our current reality
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Our Current Reality. Upper Peninsula Children’s Oral Health Summit NMU Conference Center May 17, 2014 --Kayla West, MBA. 5 Buckets. Coverage & Financing Safety Net Workforce Prevention Surveillance. Focusing on “Systems”. Remember the 1980’s—Haven’t we been here before?. - PowerPoint PPT PresentationTRANSCRIPT
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OUR CURRENT REALITY
Upper Peninsula Children’s Oral Health SummitNMU Conference Center
May 17, 2014--Kayla West, MBA
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Alger
Baraga
Chippe
waDelt
a
Dickins
on
Gogeb
ic
Hough
ton Iron
Kewee
naw
Luce
Mackin
ac
Marque
tte
Menom
inee
Ontona
gon
Schoo
lcraft
-
500
1,000
1,500
2,000
2,500
3,000
Dental Visits in 2012--Medicaid Children Ages 0-4
Total Eligible1 or More Visits
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Alger
Baraga
Chippe
waDelt
a
Dickins
on
Gogeb
ic
Hough
ton Iron
Kewee
naw
Luce
Mackin
ac
Marque
tte
Menom
inee
Ontona
gon
Schoo
lcraft
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Dental Visits in 2012--Medicaid Children Ages 0-4
No Visits1 or More Visits
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Alger
Baraga
Chippe
waDelt
a
Dickins
on
Gogeb
ic
Hough
ton Iron
Kewee
naw
Luce
Mackin
ac
Marque
tte
Menom
inee
Ontona
gon
Schoo
lcraft
-
500
1,000
1,500
2,000
2,500
3,000
Dental Visits in 2012--Medicaid Children Ages 5-14
Total Eligible1 or More Visits
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Alger
Baraga
Chippe
waDelt
a
Dickins
on
Gogeb
ic
Hough
ton Iron
Kewee
naw
Luce
Mackin
ac
Marque
tte
Menom
inee
Ontona
gon
Schoo
lcraft
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Dental Visits in 2012--Medicaid Children Ages 5-14
No Visits1 or More Visits
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Alger
Baraga
Chippe
waDelt
a
Dickins
on
Gogeb
ic
Hough
ton Iron
Kewee
naw
Luce
Mackin
ac
Marque
tte
Menom
inee
Ontona
gon
Schoo
lcraft
-
500
1,000
1,500
2,000
2,500
3,000
Dental Visits in 2012--Medicaid Children Ages 15-20
Total Eligible1 or More Visits
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Alger
Baraga
Chippe
waDelt
a
Dickins
on
Gogeb
ic
Hough
ton Iron
Kewee
naw
Luce
Mackin
ac
Marque
tte
Menom
inee
Ontona
gon
Schoo
lcraft
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Dental Visits in 2012--Medicaid Children Ages 15-20
No Visits1 or More Visits
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Alger
Baraga
Chippe
waDelt
a
Dickins
on
Gogeb
ic
Hough
ton Iron
Kewee
naw
Luce
Mackin
ac
Marque
tte
Menom
inee
Ontona
gon
Schoo
lcraft
-
500
1,000
1,500
2,000
2,500
3,000
Dental Visits in 2012—Medicaid Adults Age 21-60
Total Eligible1 or More Visits
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Alger
Baraga
Chippe
waDelt
a
Dickins
on
Gogeb
ic
Hough
ton Iron
Kewee
naw
Luce
Mackin
ac
Marque
tte
Menom
inee
Ontona
gon
Schoo
lcraft
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Dental Visits in 2012—Medicaid Adults Age 21-60
No Visits1 or More Visits
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0%
10%
20%
30%
40%
50%
60%
70%
80%
Household Income Correlated With Health Status and Access To Care
(WUP CHNA)$0 - $24,999
$25,000 - $49,999
$50,000 or more
Western UP Overall
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• Coverage & Financing
• Safety Net• Workforce• Prevention• Surveillance
5 Buckets
Focusing on “Systems”
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Remember the 1980’s—Haven’t we been here before?
• 2000 US--Former Surgeon General David Satcher’s “Silent Epidemic”• 2000 SOM--Healthy Kids Dental for Medicaid Children (22 counties)• 2000 SOM—Community Dental Clinics North – 21 counties• 2000 SOM—4th Year Dental Student Externships• State Office of Oral Health
• Fluoride Equipment Grants• Varnish! Michigan, Varnish! Michigan – Babies Too!• SEAL! Michigan
• 2003 SOM—Michigan Oral Health Coalition• 2004 Michigan Community Dental Clinics, Inc.• 2012 US—Affordable Care Act• 2014 SOM—Medicaid Expansion With Adult Dental Benefits
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Driving Distances – 30 Minute
Radius
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Distribution of Safety Net Dental Clinics
Uninsured adults only
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Which Safety Net Dental Clinics Will See Children in 2015?
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Dr. Brian Anderson--Hospital Cases (10/12 – 4/14)
Number of Cases by Year Number of Cases by Age
1 2 3 4 5 6 7 8 9 10 11 120
2
4
6
8
10
12
14
16
18
10
5
10
15
20
25
30
35
40
45
2011 2012 2013 2014
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Distribution of Hospital Cases for Children
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Hospital Cases—Dr. Brian Anderson
$ Billed vs. $ Reimbursed Billed vs. % Reimbursed
1 6 11 16 21 26 31 36 41 46 51 56 61 66 71$0
$1,000
$2,000
$3,000
$4,000
$5,000
$6,000
$7,000
1 6 11 16 21 26 31 36 41 46 51 56 61 66 710.00%
10.00%
20.00%
30.00%
40.00%
50.00%
60.00%
70.00%
80.00%
90.00%
100.00%
% Reimbursed
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Fluoridation of community water supplies is “One of the greatest public health advances of the last century.” (Centers for Disease Control and Prevention) 33% of the UP population
has access to fluoridated community water systems.
Sources: Kayla West (Oral Health for All Coalition). Map by Eric Anderson, PHD, Senior Planner, County of Marquette Data from John Clark, DEQ.
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Do Health Departments Apply Fluoride Varnish in
MIHP and WIC Programs?
Yes
Yes
Yes
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Marquette County, Pop. 67,906 (2012)
FRL = Free/Reduced Lunch• Community Water System With Fluoride• Community Water System No Fluoride
Marquette**Cherry Creek = 378,
27% FRLVandenboom = 20,
10% FRLSandy Knoll = 376,
38% FRLSuperior Hills = 294,
27% FRLGravereat = 122,
46% FRLMiddle = 860,
29% FRLHigh School = 1042,
38% FRLNorth Star = 271,
62% FRL RESA = 60 42% FR Total Students: 3,423
PowellK-8 = 46, 52% FRL
Ishpeming Birchview = 310, 55% FRLMiddle = 254, 48% FRLHigh School = 266, 36% FRL
Total Students: 830
Republic-MichigammeK-12 = 136,
63% FRL
WellsK-8 = 12, 75% FRL
Gwinn Sawyer
West Ishpeming, NICE
Aspin Ridge = 823, 32% FRLWestwood = 345, 19% FRLTotal Students: 1,168
Sawyer Elem = 285 , 87% FRLGwinn Elem = 263, 59% FRLMiddle = 262, 70% FRLHigh = 386, 51% FRLTotal Student Pop. = 1,196
Negaunee Lakeview = 738, 33% FRLMiddle = 326, 32% FRLHigh School = 421, 30% FRL Total Students: 1,485
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I’m sure glad the hole isn’t in our end…..
Source: Russell Ackoff (http://www.youtube.com/watch?v=UdBiXbuD1h4)
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END OF OVERVIEW
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LUCE COUNTYCase Study of a “Positive Deviant”
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Iron
Menom
inee
Kewee
naw
Alger
Hough
ton
Gogeb
ic
Mackin
acDelt
a
Dickins
on
Chippe
wa
Marque
tte
Schoo
lcraft
Baraga
Ontona
gon
Luce
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
What Percentage of Healthy Kids Dental Children, Ages 0-4, In Each County, Had At Least One Dental Visit in 2012?
With 1+ Dental Visits in Past Year Without Dental Visit in Past Year