oral health regional assessment & planning project (rapp)
DESCRIPTION
Greater Cincinnati, Northern Kentucky & Southeastern Indiana. Oral Health Regional Assessment & Planning Project (RAPP). 2002-2005. October 10, 2000. Cincinnati Enquirer 9/8/00. What was the RAPP?. Rising interest in dental issues Small funds available - PowerPoint PPT PresentationTRANSCRIPT
Oral Health Regional Assessment & Planning Project
(RAPP)
2002-2005
Greater Cincinnati, Northern Kentucky & Southeastern Indiana
October 10, 2000
Cincinnati Enquirer 9/8/00
What was the RAPP?Rising interest in dental issuesSmall funds availableUnited Way looking for initiativesPlanning process needed
RAPP Process CreatedUnited Way and Health Foundation fundingOral Health Council project managementAdvisory Council leadershipBroad community participation by stakeholders
How the Process Worked
Summary ofNeeds/IssuesMade Public
Steering Committee
Advisory Committee Staff Consultants
AdvisoryCommitteeProvides
InitialInput
Implement
Take Plan toCommunity
Implementprogram(s)that can be
enactedimmediately
Begindevelopment
for otherinitiatives
Oral HealthData
Demographics
Literature
Stakeholder &Consumer
Input
BestPractices
Consumer Input
Funding PlanOptions
RealityTesting
AdvisoryCommittee
Review
Stakeholder &Consumer
Input
AdvisoryCommittee
Review& Accept
Internal & External Communications
Preparation for United Way Phase II proposal
5 Months
7 Months
10 Months
Summary ofNeeds/IssuesMade Public
2 Months
ProgramDraft
FinalProgramDesign
DraftImplementation
Plan
FinalImplementation
Plan
Transition Period
What We Found
Economic Culturalconditions norms
Historical Mediatrends messages
Public sectorpractices
Private sector practices
Neighborhood Systemcharacteristics relationships
Family Personalcharacteristics choices
Health caresystem practices
Educationalsystem practices
Families @ 200% of the FPL
Lack Access toDental Care(~450,000)
Multiple factors in the community contribute to poor dental access to care
Multiple factors in the community contribute to poor dental access to care
• Tooth decay is on the rise – more than 45% of inner city children have untreated decay• Emergencies cases have tripled at the Cincinnati Health Dept. Clinics over the past 8 years.• Existing dental clinics are at capacity
• No sliding scale dental clinics in some counties; discounts often insufficient for working poor & others• Some areas have no prevention, education or treatment programs• Families choose rent, food, clothing over dental care
Multiple factors in the community contribute to poor dental access to care
• Impact on employment potential
• Culture of poverty – --postpone treatment--poor appointment compliance
• Perpetuating norms of tooth loss• Dental pain & infection is the #1
one reason why people go to the University Hospital Emergency Room.
Multiple factors in the community contribute to poor dental access to care
RecommendationsWhat should each county have? Treatment for pain & infection Basic restorative care Essential esthetics Effective early prevention Effective educational programs Water fluoridation
Recommendations Improved Preventionsealants, use of pediatricians & ob/gyns, oral cancer exams, mouthguards Increased Educationhealth promotion & education on the importance of oral health community-wide Expanded Access to TreatmentExpand and build, lower fees, Urgent Care Center, dental vans
Regionalized Efforts
Public PolicyProvider EducationHead Start & School SupportMRDD ProgramNursing Home ProgramStrategies for cultural competence/relevance
Public Policy Recommendations
Gain Public/government financing/support
Improving state Medicaid programs
Exploring new systems to provide care
Strategies for addressing cultural needs & disparities
Training for dentists & staffs Training in dental schools Mentoring programs for children from low income/minority families to develop dental careers.
Early AccomplishmentsSealant Program in Northern KentuckyMobile van for Cincinnati Public SchoolsUH GP residency programClermont County Head Start dental projectBabies Milk Fund/Rocking Horse fluoride varnish pilot in pediatric officesOctober 6, 2002 Enquirer articleExpansion of Lincoln Hgts. Clinic2 school-linked dental programsNorthern Ky Clinic expansionFluoride varnish programsCincinnati Dental Society clinic
Cost
One tenth of 1% of the region’s total health care expenditures $13 million
of $13 billion health expenditures per year in the region
Funding PossibilitiesShifts in prioritiesUser taxes(sugar-based drinks, candy)Share of leviesNew levyDental insurance underwriters assessment“Sales Tax” on dental fees
An integrated, collaborative system
with community involvement at the nucleus
Community-developed
CoordinationNucleus
Treatment
Policy
Prevention
Education
Current Status: Rebirth? Internal changes at United Way= end of funding and support 2 year gap prior to publication. Some progress continues Advisory Committee & Oral Health Council intend to continue with
plan implementation.