HEAD START HAWAII ORAL HEALTH STRATEGIC PLAN
JANUARY 2003
Head Start State Collaboration Project
Head Start Association of Hawaii
Benefit, Employment, & Support Services Div.
Wailuku, Hawaii 96793
Department of Human Services
Haseko Center, 820 Mililani St., #606
Honolulu, Hawaii 96813-2936
Jacqueline Rose, Director
99 Mahalani Street
Lyn McNeff, President
Department of Health
1700 Lanakila Ave., #203
Honolulu, Hawaii 96817
Dental Health Division:
Dr. Mark H.K. Greer, D.M.D. M.P.H., Chief
Dental Hygiene Branch:
Susan L. Tengan, Chief
WIC Services Branch
235 S. Beretania St., #701
Honolulu, Hawaii 96813
Linda Chock, Chief
HEAD START STATE ORAL HEALTH STRATEGIC PLAN
TABLE OF CONTENTS
Page
I.
Increase Access to Urban & Rural Providers through System, Profession, and Head Start Program changes . . . . . . . . . .
II.
Increase Access to Resources/Information for Urban & Rural Users
III.
Oral Health Education for Head Start and Community
IV.
Prevention . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1– 9
.........................................
10 – 14
....................................................
15 – 24
25 – 28
Addendum:
Addendum A – Resources
..........................................................................
Addendum B – Barriers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
** note: only Addendum A and B are included in this file
A1
B1 – B3
Addendum C – Direct Access Urban Only . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
C1 – C13
Addendum D – Direct Access Rural Only
...............................................................
D1 – D8
Addendum E – Head Start Performance Standards Related to Oral Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
E1 – E5
Addendum F – Early and Periodic Screening, Diagnosis and Treatment (EPSDT)
Periodic Screening Guidelines . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
F1 – F3
ISLAND:
I.
OAHU
MAUI
MOLOKAI
LANAI
HILO
KONA
KAUAI
ALL ISLANDS
INCREASE ACCESS TO URBAN & RURAL PROVIDERS THROUGH SYSTEM, PROFESSION, AND HEAD START PROGRAM
CHANGES
Objective:
A. Improve Medicaid System
Accountability
Strategy & Action Steps
Primary
Others
Schedule
Start
Complete Money
Resources
Time
Feedback System
Other
Measure
Frequency Mechanism
1. Increase medicaid reimbursement
to dental providers
• Discuss with Department of
Human Services (DHS) to
determine action steps
• Report to Head Start Task
Force
2. Simplify claims process for Dentists
• Discuss with DHS to determine
action steps
3. Improve Medicaid verification
process
4. Implement pregnancy related only
dental coverage
• Provide information to MedQuest regarding oral conditions
could negatively affect the
pregnancy outcome.
NOTE: Rural only strategies are identified as (R)
5
ISLAND:
I.
OAHU
MAUI
MOLOKAI
LANAI
HILO
KONA
KAUAI
ALL ISLANDS
INCREASE ACCESS TO URBAN & RURAL PROVIDERS THROUGH SYSTEM, PROFESSION, AND HEAD START PROGRAM
CHANGES
Objective continued:
A. Improve Medicaid System
Accountability
Strategy & Action Steps
5. Legislation to restore adult dental
benefits
Primary
Others
Schedule
Start
Complete Money
Resources
Time
Feedback System
Other
Measure
Frequency Mechanism
6. Develop an Early Periodic
Screening Diagnosis Treatment
(EPSDT) Memorandum of
Understanding (MOU) between
DHS and Head Start*
7. Train Head Start staff to become
Med-Quest Outreach workers to
expedite application process (R)
8. Quest intake workers assist Head
Start (HS) families to fill out
applications at Head Start sites (R)
NOTE: Rural only strategies are identified as (R)
*See addendum F for EPSDT Periodic Screening Guidelines
6
ISLAND:
I.
OAHU
MAUI
MOLOKAI
LANAI
HILO
KONA
KAUAI
ALL ISLANDS
INCREASE ACCESS TO URBAN & RURAL PROVIDERS THROUGH SYSTEM, PROFESSION, AND HEAD START PROGRAM
CHANGES
Objective:
B. Develop partnerships with providers to meet the needs of Head Start Children & Families
Accountability
Strategy & Action Steps
1. Mobilize committed dentists to
mentor/motivate/influence/educate
other dentists to participate in
treating special at risk populations
including our children with special
needs and children 0-6 (R)
• Statewide by county publicized
campaign (R)
• Collect Head Start oral health
data to substantiate needs to
share with community, state &
federal policy makers (R)
• Additional training for dentists
to treat young children 0-6 and
children with special needs (R)
Primary
Others
Schedule
Start
Complete Money
Resources
Time
Feedback System
Other
Measure
Frequency Mechanism
7
ISLAND:
I.
OAHU
MAUI
MOLOKAI
LANAI
HILO
KONA
KAUAI
ALL ISLANDS
INCREASE ACCESS TO URBAN & RURAL DENTAL PROVIDERS THROUGH SYSTEM, PROFESSION, AND HEAD START PROGRAM
CHANGES
Objective continued:
B. Develop partnerships with providers to meet the needs of Head Start Children & Families
Accountability
Strategy & Action Steps
2. Reduce barriers to provider
participation
• Develop methods/procedures
to reduce missed appointments
•
Primary
Others
Schedule
Start
Complete Money
Resources
Time
Feedback System
Other
Measure
Frequency Mechanism
Approach other dentists to
encourage their peers to
provide services to children
Chairside manners (standards
of behavior/rural dentistry) (R)
3. Develop plans for clinic days that
are devoted to prevention, young
children, pregnant women
•
Convene committee
•
Develop the concept for clinic
days
•
Present concept to dental
professionals
8
ISLAND:
OAHU
MAUI
MOLOKAI
LANAI
HILO
KONA
KAUAI
ALL ISLANDS
I. INCREASE ACCESS TO URBAN & RURAL DENTAL PROVIDERS THROUGH SYSTEM, PROFESSION, AND HEAD START PROGRAM
CHANGES
Objective continued:
B. Develop partnerships with providers to meet the needs of Head Start Children & Families
Accountability
Strategy & Action Steps
4. Improve relationship with
pediatricians to increase
involvement for early identification
of dental problems
• Training to identify dental
disease
• Training to complete oral health
portion of health form
• CEU for pediatrician on early
intervention for oral health
Primary
Others
Schedule
Start
Complete Money
Resources
Time
Feedback System
Other
Measure
Frequency Mechanism
5. Head Start programs to establish
relationship with dental
professionals (dentist or hygienist)
to assist with identification of oral
disease and referrals
• Licensed dental professional
employed by Head Start
programs (R)
9
ISLAND:
OAHU
MAUI
MOLOKAI
LANAI
HILO
KONA
KAUAI
ALL ISLANDS
I. INCREASE ACCESS TO URBAN & RURAL DENTAL PROVIDERS THROUGH SYSTEM, PROFESSION, AND HEAD START PROGRAM
CHANGES
Objective continued:
B. Develop partnerships with providers to meet the needs of Head Start Children & Families
Accountability
Strategy & Action Steps
6. Head Start programs establish &
promote Dental Home Concept
Primary
Others
Schedule
Start
Complete Money
Resources
Time
Feedback System
Other
Measure
Frequency Mechanism
7. Volunteer service learning model
for Hawaii Dental Association
(HDA), Hawaii Dental Hygienists’
Association (HDHA), University of
Hawaii School of Nursing and
Dental Hygiene, University of
Hawaii School of Medicine, city and
counties)
•
Convene stakeholders
•
•
Develop a feasible plan
Bring dentist to program with
dental chair
10
ISLAND:
OAHU
MAUI
MOLOKAI
LANAI
HILO
KONA
KAUAI
ALL ISLANDS
I. INCREASE ACCESS TO URBAN & RURAL DENTAL PROVIDERS THROUGH SYSTEM, PROFESSION, AND HEAD START PROGRAM
CHANGES
Objective continued:
B. Develop partnerships with providers to meet the needs of Head Start Children & Families
Accountability
Strategy & Action Steps
8. Reduction of school debt incentive
to work with Medicaid patient
(AMERICORPS) (R)
Primary
Others
Schedule
Start
Complete Money
Resources
Time
Feedback System
Other
Measure
Frequency Mechanism
9. Work with HDA to see children 6
months – 5 years of age
10. Appeal to local dentists to assist
children/family in their community
(donate space & equipment if they
don’t serve low-income) Molokai,
Lanai, Hilo, Kona, Maui
11
ISLAND:
I.
OAHU
MAUI
MOLOKAI
LANAI
HILO
KONA
KAUAI
ALL ISLANDS
INCREASE ACCESS TO URBAN & RURAL DENTAL PROVIDERS THROUGH SYSTEM, PROFESSION, AND HEAD START PROGRAM
CHANGES
Objective:
C. Provide services in various clinical settings (including West Oahu)
Accountability
Strategy & Action Steps
Primary
Others
Schedule
Start
Complete Money
Resources
Time
Feedback System
Other
Measure
Frequency Mechanism
1. Community clinics that include
dental care on every island (R)
• Legislation to fund dental clinics
on every island
• Build a community clinic with
dental services on West Oahu
2. Increase number of mobile dental
units “Tooth Mobile” (R)
• Hawaii (Big Island) Mobile van
service – once a week per site
• Kauai Mobile van – once a
week – primary clinic
• Maui Mobile van – partner with
dental assistant school
3. One stop service center (medical,
dental, & mental) (R)
•
Community needs assessment
•
Apply for funding
12
ISLAND:
OAHU
MAUI
MOLOKAI
LANAI
HILO
KONA
KAUAI
ALL ISLANDS
I. INCREASE ACCESS TO URBAN & RURAL DENTAL PROVIDERS THROUGH SYSTEM, PROFESSION, AND HEAD START PROGRAM
CHANGES
Objective:
D. Head Start Association to define policy on State Legislative Issues
Accountability
Strategy & Action Steps
Primary
Others
Schedule
Start
Complete Money
Resources
Time
Feedback System
Other
Measure
Frequency Mechanism
1. Develop legislative Task Force
Committee.
•
Dental Hygienist Practice Act
•
Dental licensure issues
•
Restore adult dental benefits
•
Fluoridation
Economic incentive for
providing services in high need
areas and to children (R)
Pre-kindergarten dental
clearance
Funding for additional dental
clinics (R)
Funding for one-step service
centers (medical, dental,
mental) (R)
•
•
•
•
13
ISLAND:
OAHU
MAUI
MOLOKAI
LANAI
HILO
KONA
KAUAI
II. INCREASE ACCESS TO RECOURCES AND INFORMATION FOR USERS
ALL ISLANDS
URBAN & RURAL
Objective:
A. Identify & increase utilization of current resources
Accountability
Strategy & Action Steps
Primary
Others
Schedule
Start
Complete Money
Resources
Time
Feedback System
Other
Measure
Frequency Mechanism
1. Develop one stop shop concept
linking families to resources in
community
2. Utilize Department of Human
Service’s (DHS) process to help
families access care at intake
3. Identify & assist families who
under utilize their insurance
coverage
4. Use Keiki play groups to
education/dental screening
(screening library/mini workshops)
(R)
5. Assist families to be more effective
participants in Medicaid (R)
•
Medicaid dental card
14
• Other processes
ISLAND:
OAHU
MAUI
MOLOKAI
LANAI
HILO
KONA
KAUAI
ALL ISLANDS
II. INCREASE ACCESS TO RESOURCES AND INFORMATION FOR USERS
URBAN & RURAL
Objective:
B. Improve assurance of care within every Head Start Program
Accountability
Strategy & Action Steps
1. Establish follow-up strategy for oral
health tracking i.e. Activity/Service
Delivery Tracking (ASDT)
Primary
Others
Schedule
Start
Complete Money
Resources
Time
Feedback System
Other
Measure
Frequency Mechanism
2. Head Start Programs share
strategies to meet federal
mandates
3. Provide incentives to Head Start
families to seek regular dental care
• Support legislation for dental
clearance at kindergarten entry
4. Locate resources for gap groups
(under-or-uninsured)
15
ISLAND:
OAHU
MAUI
MOLOKAI
LANAI
HILO
KONA
KAUAI
II. INCREASE ACCESS TO RESOURCES AND INFORMATION FOR USERS
ALL ISLANDS
URBAN & RURAL
Objective:
C. Partner with agencies to develop new resources
Accountability
Strategy & Action Steps
Primary
Others
Schedule
Start
Complete Money
Resources
Time
Feedback System
Other
Measure
Frequency Mechanism
1. Train & develop protocol for
Women, Infants and Children
(WIC) to provide pre-natal, post
birth and ongoing assessment of
good oral health
•
Identify trainer/training
•
Provide the training
•
Add educational/assessment to
WIC protocol
Add dental incentive program to
assure success
Explore dental hygienist as
alternative to staff trainer
•
•
2. Train para-professionals & parents
to provide oral screenings
16
ISLAND:
OAHU
MAUI
MOLOKAI
LANAI
HILO
KONA
KAUAI
II. INCREASE ACCESS TO RESOURCES/INFORMATION FOR USERS
ALL ISLANDS
URBAN & RURAL
Objective continued
C. Partner with agencies to develop new resources
Accountability
Strategy & Action Steps
Primary
Others
Schedule
Start
Complete Money
Resources
Time
Feedback System
Other
Measure
Frequency Mechanism
3. Train medical students, interns, &
residents in oral health screening &
referral techniques
4. Explore development of protocol in
dental hygiene school to provide
oral screenings
5. Develop county transportation
plans to transport Head Start
children/families to providers
6. Request National Health Service
Corps (NHSC), a federal program
to assign dentists to work in
Hawaii’s underserved areas (R)
17
ISLAND:
OAHU
MAUI
MOLOKAI
LANAI
HILO
KONA
KAUAI
II. INCREASE ACCESS TO RESOURCES/INFORMATION FOR USERS
ALL ISLANDS
URBAN & RURAL
Objective continued:
C. Partner with Agencies to develop new resources
Accountability
Strategy & Action Steps
7. Provide training & seminars to
increase & support partnerships
statewide (R)
• Establish an Oral Health Task
Force Committee
• Plan and convene a Statewide
Head Start Oral Health
Conference
Primary
Others
Schedule
Start
Complete Money
Resources
Time
Feedback System
Other
Measure
Frequency Mechanism
18
ISLAND:
III.
OAHU
MAUI
MOLOKAI
LANAI
HILO
KONA
KAUAI
ALL ISLANDS
ORAL HEALTH EDUCATION FOR HEAD START & COMMUNITY
Objective:
A. Develop partnerships to increase educational opportunities
Accountability
Strategy & Action Steps
Primary
Others
Schedule
Start
Complete Money
Resources
Time
Feedback System
Other
Measure
Frequency Mechanism
1. Med-Quest pays for dental
hygienists to teach dental care in
schools/preschools/parent
groups/service providers
• Approach Dental Hygiene
Association regarding interest
• Solicit funding from Area Health
Education Centers (AHEC) to
cover transportation costs for
outreach
• Suggest State Collaboration
Project present Head Start
need and dental plan to MedQuest
2. Med-Quest to offer reward system
to Head Start families for good
dental practices and participation in
educational activities
• Approach Med-Quest regarding
value of prevention; present
Head Start information & data
to substantiate need for
prevention education
19
ISLAND:
III.
OAHU
MAUI
MOLOKAI
LANAI
HILO
KONA
KAUAI
ALL ISLANDS
ORAL HEALTH EDUCATION FOR HEAD START & COMMUNITY
Objective continued:
A. Develop partnerships to increase educational opportunities
Accountability
Strategy & Action Steps
2. continued
• Approach American Dental
Association to collaborate with
Med-Quest regarding the value
of prevention and develop
promotion/incentives for best
preventive practices (ie.
minimum standards of service)
• Approach corporate sponsors
for incentive prizes
Primary
Others
Schedule
Start
Complete Money
Resources
Time
Feedback System
Other
Measure
Frequency Mechanism
3. Media coverage/awareness
statewide
• Public Service Announcements
(PSA’s) on baby bottle mouth &
importance of good oral health
a. Collaborate with DOH,
Community Health Division
and the Living Healthy
Hawaii Campaign
b. Na Leo and Limon Medeiros
on West Hawaii help with
campaign
c. Identify “champions” and
assist their efforts
20
ISLAND:
OAHU
MAUI
MOLOKAI
LANAI
HILO
KONA
KAUAI
ALL ISLANDS
III. ORAL HEALTH EDUCATION FOR HEAD START & COMMUNITY
Objective continued:
A. Develop partnerships to increase educational opportunities
Accountability
Strategy & Action Steps
3. Media coverage/awareness
statewide continued
d. Submit articles to the
newspapers
e. Olelo type community
messages-public television
f. Radio Stations
Primary
Others
Schedule
Start
Complete Money
Resources
Time
Feedback System
Other
Measure
Frequency Mechanism
g. Find local artists to do
promotion for oral health
4. Hawaii Dental Association/Hawaii
Dental Hygienists’ Association
•
•
•
Publish in their newsletter
Create a linkage with Head
Start
Reach providers in their own
professional meetings or
gatherings
21
ISLAND:
OAHU
MAUI
MOLOKAI
LANAI
HILO
KONA
KAUAI
ALL ISLANDS
III. ORAL HEALTH EDUCATION FOR HEAD START & COMMUNITY
Objective continued:
A. Develop partnerships to increase educational opportunities
Accountability
Strategy & Action Steps
5. Utilize Head Start Association of
Hawaii (HSAH) for dissemination
of information
Primary
Others
Schedule
Start
Complete Money
Resources
Time
Feedback System
Other
Measure
Frequency Mechanism
6. Utilize Head Start State
Collaboration Project for
dissemination of information
7. Utilize Head Start Health Services
Advisory Committees
• Encourage local dentists to
participate on the Health
Services Advisory Committee
• Send dental Head Start
information to local dentists on
a consistent basis to encourage
their involvement
a. Identify funding sources
b. Develop mailing list
c. Design and determine
content of materials
d. Consistent with mailing
items
22
ISLAND:
OAHU
MAUI
MOLOKAI
LANAI
HILO
KONA
KAUAI
ALL ISLANDS
III. ORAL HEALTH EDUCATION FOR HEAD START & COMMUNITY
Objective continued:
A. Develop partnerships to increase educational opportunities
Accountability
Strategy & Action Steps
7. Utilize Head Start Health Services
Advisory Committees continued
e. Periodic acknowledgement of
participating dentists using
media
Primary
Others
Schedule
Start
Complete Money
Resources
Time
Feedback System
Other
Measure
Frequency Mechanism
8. Quest Outreach
• Each Head Start to identify a
contact person to attend
quarterly Quest meetings and
report Head Start concerns
• Educate parents on coverage
for increased utilization
23
ISLAND:
OAHU
MAUI
MOLOKAI
LANAI
HILO
KONA
KAUAI
ALL ISLANDS
III. ORAL HEALTH EDUCATION FOR HEAD START & COMMUNITY
Objective continued:
A. Develop partnerships to increase educational opportunities
Accountability
Strategy & Action Steps
9. Educate dental professionals,
legislators and partners on oral
health regarding:
•
Family needs
•
Dental home concept
•
•
Oral health data
Existing Head Start
collaborations
Integrated health (body, teeth,
overall health)
•
Primary
Others
Schedule
Start
Complete Money
Resources
Time
Feedback System
Other
Measure
Frequency Mechanism
10. Educate Medical Professionals
• Approach University of Hawaii
School of Medicine (Dyson
Project) regarding the
development and inclusion of a
dental component for medical
interns ie: a practicum in
schools including an outreach
to neighbor islands
24
ISLAND:
III.
OAHU
MAUI
MOLOKAI
LANAI
HILO
KONA
KAUAI
ALL ISLANDS
ORAL HEALTH EDUCATION FOR HEAD START & COMMUNITY
Objective:
B. Provide educational resources
Accountability
Strategy & Action Steps
Primary
Others
Schedule
Start
Complete Money
Resources
Time
Feedback System
Other
Measure
Frequency Mechanism
1. Research current oral health
curriculum for Early Head Start &
Head Start
•
Review by program criteria
•
Select
•
Purchase
•
Distribute
2. Develop “family friendly” brochures
on dental care
•
Translate as needed
•
Make available everywhere
3. Develop lending library of dental
videos & other resources for
families/staff to access
25
ISLAND:
OAHU
MAUI
MOLOKAI
LANAI
HILO
KONA
KAUAI
ALL ISLANDS
III. ORAL HEALTH EDUCATION FOR HEAD START & COMMUNITY
Objective continued:
B. Provide educational resources
Accountability
Strategy & Action Steps
Primary
Others
Schedule
Start
Complete Money
Resources
Time
Feedback System
Other
Measure
Frequency Mechanism
4. Replicate dental “Adopt-A-Center”
program in all Head Start programs
5. Participate in health fairs
26
ISLAND:
III.
OAHU
MAUI
MOLOKAI
LANAI
HILO
KONA
KAUAI
ALL ISLANDS
ORAL HEALTH EDUCATION FOR HEAD START & COMMUNITY
Objective:
C. To increase Head Start parents knowledge of oral health & support their ability to pass it on to their children &
to each other
Accountability
Strategy & Action Steps
Primary
1. Parent education on oral health
basics
• Utilize current curriculum with
parents
• Monthly parent group meeting &
home visits
Others
Schedule
Start
Complete Money
Resources
Time
Feedback System
Other
Measure
Frequency Mechanism
2. Parents teaching parents (talk story
style)
• Identify and incorporate parent
training programs to work with
Head Start staff to educate
Head Start parents (train the
trainers)
• Establish a “buddy system” to
provide support to the parent
presenters when parents
provide oral health education
• Establish a point system/reward
for parent volunteers with
recognition for their efforts
(recognition ceremony)
27
ISLAND:
OAHU
MAUI
MOLOKAI
LANAI
HILO
KONA
KAUAI
ALL ISLANDS
III. ORAL HEALTH EDUCATION FOR HEAD START & COMMUNITY
Objective continued:
C. To support Head Start parents knowledge of oral health & support their ability to pass it on to their children &
community
Accountability
Strategy & Action Steps
3. Parent “”Champions” that are
willing to spread information
• Identify parents and growing
parent champions and assist
them to spread the information
• Head Start help nurture these
parent champions
Primary
Others
Schedule
Start
Complete Money
Resources
Time
Feedback System
Other
Measure
Frequency Mechanism
4. Provide incentive for parents
Make trainings “family friendly”
Complete oral health activities
28
ISLAND:
IV.
OAHU
MAUI
MOLOKAI
LANAI
HILO
KONA
KAUAI
ALL ISLANDS
PREVENTION
Objective:
A. Fluoride delivery
Accountability
Strategy & Action Steps
Primary
Others
Schedule
Start
Complete Money
Resources
Time
Feedback System
Other
Measure
Frequency Mechanism
1. Community water fluoridation
•
•
Legislation
Educate Head Start community
to benefits
2. Bottled water with fluoride
3. Fluoride supplementation
4. Fluoride rinse
5. Fluoridated toothpaste
29
ISLAND:
IV.
OAHU
MAUI
MOLOKAI
LANAI
HILO
KONA
KAUAI
ALL ISLANDS
PREVENTION
Objective:
B. Preventive strategies other than fluoride
Accountability
Strategy & Action Steps
Primary
Others
Schedule
Start
Complete Money
Resources
Time
Feedback System
Other
Measure
Frequency Mechanism
1. Sealants
2. Connect nutrition to oral health
• Work with school food service
program to ensure healthy,
nutritious meals
30
ISLAND:
OAHU
MAUI
MOLOKAI
LANAI
HILO
KONA
KAUAI
ALL ISLANDS
IV. PREVENTION
Objective:
D. Provide continuance of Head Start oral health standards into public schools/private school system*
Accountability
Strategy & Action Steps
Primary
Others
Schedule
Start
Complete Money
Resources
Time
Feedback System
Other
Measure
Frequency Mechanism
1. Support continuation of Head Start
oral health standards in on-going
educational setting for all children
•
•
•
•
Pre-entry kindergarten dental
exam
Regular dental visits with
documented completion
In-school support for oral
hygiene preventive practices
during school hours
Classroom education
*See Addendum E for Head Start Performance Standards Related to Oral Health
31
ISLAND:
OAHU
MAUI
MOLOKAI
LANAI
HILO
KONA
KAUAI
ALL ISLANDS
IV. PREVENTION
Objective:
C. Locate funding for oral health prevention
Accountability
Strategy & Action Steps
1. Redistribute dental division funding
among islands on a per capita
basis
Primary
Others
Schedule
Start
Complete Money
Resources
Time
Feedback System
Other
Measure
Frequency Mechanism
32
ADDENDUM A
RESOURCES
Statewide:
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
Community Heath Center/FQHC’s
Native Hawaiian Healthcare Systems (Case Mgt).
WOMEN, Infant and Children (WIC)
Toll free # for Medicaid/Quest for dental service and transportation.
Head Start Health Services Advisory Committees.
Hawaii Dental Association
Hawaii Dental Hygienists’ Association
Head Start Association of Hawaii
Good Beginnings Alliance Coordinators
Good Beginnings Alliance Keiki Playgroups
O’lelo Public Television
Catholic Charities
Ronald McDonald
Primary Care
Native Hawaiian Health System/Ho’ola
Hawaii Medical Service Association
Hawaii Dental Services
Hawaii State Oral Health Coalition
Boys and Girls Clubs of Hawaii (BGCH)
“Saving young smiles Day”
Hawaii Dental Education Center
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Working with State Dental Taskforce – remove old dental clinic.
New dentist on island.
Collaboration DOH/HS/Tri-county Oral Health task force.
Hawaii:
2 Mobile dental/caravans.
CHC’s – 3 sites : open in Kea’au next Honokaa
Collaboration DOH/HS/Tri-county Oral Health task force.
Maui:
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CHC – CCM
Hana
Renovating clinic
Opening CHC on Molokai.
Oahu:
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Waianae CHC
• Waimanalo CHC
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Kahuku Hospital/clinic
More dentists on Oahu than other islands
Dental Samaritans
University school of Nursing and Dental Hygiene
Kauai:
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Community Health Clinic (CHC) in Waimea.
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ADDENDUM B
HEAD START STATE ORAL HEALTH PLAN
BARRIERS
Governmental Policies:
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No community fluoridation support.
Medicaid reimbursement rate and paperwork/payment process, no show problem, co-payment, only allow 30 day prescriptions.
No kindergarten entry requirement for dental certificate.
Access Barriers:
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Limited services available on Molokai i.e. families have to travel to Maui/Oahu.
Families have to pay co-payment.
Separate provider for adult and child.
Lack of information about dental resources/services for families.
# Of Pediadontists in community clinics.
Providers in community lack training in child development.
Providers do not recognize Oral Health needs of 0-3 yr. Olds i.e. “wait till later”. (prevention versus examination/treatment).
Difficulty getting appointments in timely manner.
Lack of emergency care system.
No Hawaii dental school.
Lack of private & public providers/clinics.
Dentists are selective with clients (insurance, # of patients, etc.)
Providers unfamiliar with Head Start.
Lack of adult dental services.
Hygienists not allowed to go into schools.
Cultural barriers:
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Mothers chew food to give to babies – possible transmission of disease/bacteria.
Immigrant families unaccustomed to preventive care practices. “crisis” dental care (access services only for emergencies).
Late use of bottles even into 3rd – 5th year of life.
“Juice” is good – therefore juice in baby bottles vs. water or milk.
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Ashamed to ask for help.
Fear of using state services.
Missing and/or decayed teeth are not a stigma.
Language ESL i.e. 27 languages and translated materials.
Economics:
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Affects accessibility/availability of dental care.
Lack of insurance or under insurance (e.g. only covers cleaning).
Priority of dental care vs. medical care, housing, food & clothing.
Location:
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No transportation to services and pharmacy.
Education:
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Finding Dental professionals to conduct training at times workable for parents & Head Start staff.
Literacy-unable to read information
Do not understand oral disease is infectious and transmittable
Lack of parent education regarding usage of Med-Quest, dental office, manners, oral hygiene practice, and compliance with using fluoride tablets.
Past experience with dentists – painful, fearful memories
Lack of monitoring of EPSDT dental screenings (may be training issue).
Lack of education regarding general health and dental health (disconnect).
Lack of updated Head Start dental curriculum materials.
Adequate time to provide training for parents and staff.
Motivating parents to attend training.
Educate policy makers on oral health issues faced by Head Start families.
Other:
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Friction between primary care provider and dentist as to who’s role is what.
Lack of good nutrition with food service providers.
Lack of Dental provider’s representation on Head Start Association Hawaii Board.
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