UCSF Public Health UCSF Public Health Seminar SeriesSeminar Series

Rolande Tellier LoftusProgram Director

May 15, 2007

OverviewOverview

• What is POHAP?• POHAP: Past, Present and Future• Applicant Profile• Program Challenges and Successes

What is POHAP?What is POHAP?

• Program Partners:– CDA Foundation– CA Society of Pediatric Dentistry– L. A. Oral Health Foundation (L.A.

County)

• Program Funders:– L.A. Care Health Plan– First 5 L.A.– The California Endowment

POHAP: The PastPOHAP: The Past

• 2000: CSPD, CDA and Delta Dental Denti Cal Outreach– 21 hours didactic– Simulation lab “bench” training– 2-3 days on-site in a pediatric dentist’s office– 25-hour oral conscious sedation course

• Didactic training tested in 2001• Funding not available to complete the

project

POHAP: The PastPOHAP: The Past

• 2003: L.A. Care Health Plan’s Community Health Initiative

• Funding available to provide training to 50 general dentists in Los Angeles County

• Ability to add a module on children with special health care needs and videotape Dr. Paul Casamassimo

POHAP: The PastPOHAP: The Past

• Continuation funding received from L.A. Care in 2004

• Created online modules for didactic materials; built Mediapod

• Program fulfillment for continuing education credit

• Additional correspondence with participants for reporting

Baseline Data

LAPOHAP I2003

(50 DDS)

LAPOHAP II2004

(45 DDS) Total

Current number of patients ages 0 - 5?

6,378 6,356 12,734

Current number of special needs patients?

147 2,618 2,765

Quarterly Report Data LAPOHAP I LAPOHAP II Total

New Patients 0-5 Years Old 1,303 5,346 6,649

New Special Needs Patients 116 576 692

Referred Out*due to complexity of case 98 292 390

OCS*utilized oral conscious sedation 219 428 647

Prophies 1,908 4,804 6,712

Fillings 3,475 7,600 11,075

Stainless Steel Crowns 908 2,142 3,050

Pulpotomies 1,059 2,765 3,824

Extractions 960 2,331 3,291

Los Angeles ResultsLos Angeles Results

Pro Bono Reporting Form Data LAPOHAP I LAPOHAP II Total

Total Pro Bono Patients 346 647 993

Prophies 317 591 908

Fillings 1,329 2,182 3,511

Stainless Steel Crowns 458 732 1,190

Pulpotomies 465 890 1,355

Extractions 290 454 744

Participant Compliance LAPOHAP I LAPOHAP II Combined Average

Quarterly Reporting Fulfillment*reporting forms submitted 45% 77% 61%

Pro Bono Fulfillment*completed at least 18 pro bono children 18% 62% 40%

Pro Bono Fulfillment*completed less than 18 pro bono children 56% 86% 71%

Mentoring Completed 66% 80% 70%

Oral Conscious Sedation Permit 52% 28% 40%

Treatment Values (based on 70% of LA UCR's) LAPOHAP I LAPOHAP II Total

Fee For Service*children with insurance 1,122,716 3,200,359 4,323,075

Pro Bono*children without insurance or financial means 404,796 691,097 1,095,893

POHAP: The PresentPOHAP: The Present

• Funded by The California Endowment• Revisions include:

– Expand age range to 0 – 12 years of age– Replace OCS training with nitrous oxide

and local anesthesia– Addition of Regional Care Coordinators– Live lectures vs. online

POHAP: The PresentPOHAP: The Present

• 32-hour continuing education course for general dentists

• Pediatric dentistry topics include:– Prevention– Diagnosis and Treatment Planning– Children with Special Health Care Needs– Behavior Management– Restorative Materials– Nitrous Oxide and Local Anesthesia– Case Presentations and Hands-on Bench Training

POHAP: The PresentPOHAP: The Present

• Trainings completed:– Greater Sacramento Region

• 25 participants• Cover the Kids

– San Francisco Bay Area Region• 45 participants• RCC not identified

– Orange County / San Diego Region• 35 participants• Healthy Smiles for Kids of OC and Share the

Care

POHAP: The FuturePOHAP: The Future

• Trainings to be held:– Late Fall 2007:

• Los Angeles County (funded by L.A. Care Health Plan and First 5 L.A.)

– Early 2008:• Northern California• Central Valley• Orange County / San Diego/ Imperial

cdafoundation.org/programs_pohapcdafoundation.org/programs_pohap

Applicant Profile Applicant Profile (current project)(current project)

• Years in practice:– 69: less than 5 years– 32: 6 – 10 years– 22: 11 – 20 years– 20: 20+ years

• Dental School– 74: California dental school– 40: Other U.S. dental school– 30: Foreign trained

Applicant ProfileApplicant Profile

• Ethnicity– 67: Asian – 38: White – 16: Hispanic– 10: Other – 6: Black– 5: Pacific Islander– 2: American Indian

• Gender– 74: Female– 37: Male– 30: no response

Applicant ProfileApplicant Profile

• Role in Practice: – 62: Owner – 57: Employee– 21: Associate– 1: Volunteer

• Sedation:– 6 have oral conscious sedation

certificate for minors– 74 have offices equipped with nitrous

oxide

Applicant ProfileApplicant Profile

• Percent of patients with Denti-Cal:– 57: less than 10%– 39: 11% - 49%– 44: over 50%

• Percent of patients with other public insurance:– 72: less than 10%– 61: 11% - 49%– 8: over 50%

Applicant ProfileApplicant ProfileLanguages Spoken in PracticeLanguages Spoken in Practice

• Spanish: 141• Farsi: 31• Chinese: 25• Vietnamese: 26• Hindi: 14• Tagalog: 9• Punjabi: 8

• Others:– Arabic– Fillipino– French– German– Korean– Armenian– Japanese– Hmong– Russian

Program ChallengesProgram Challenges

• Recruitment beyond Los Angeles County• Oral Conscious Sedation certificate for

minors• Low response to RCC request for proposals• “Pro-bono” care• Mentoring component• Implementation in rural areas

Program SuccessesProgram Successes

• Outreach in Plumas County• Practice changes in Sacramento

office• Collaboration among participants• Involvement beyond POHAP

– Obtaining pediatric specialty– CSPD and Special Care Dentistry

Thank You!Thank You!

Questions?