Transcript Title

Providing Dental Services in
School-Based Health Centers:
Lessons from the
Caring for Kids Program
Nancy Eichner, MUP, Senior Program Manager
The Center for Health and Health Care in Schools
June 15, 2006
National Assembly on School-Based Health Care
Annual Conference, Portland, OR
The Center for
Health and Health Care in Schools
Caring for Kids Program
History
• 3 – year initiative of the Robert Wood
Johnson Foundation, announced in 2001
• 58 applicants received for 3 types of
programs (Sealants, comprehensive,
school-community partnerships)
• 7 grant awards February 2002
• Average award: $225,000
Dental Health Grantees
• Methodist Health Care Ministries
San Antonio, TX
• Montefiore Medical Center, Bronx, NY
• Columbia University, NYC, NY
• Samuel U. Rodgers CHC, Kansas City, MO
• St. John’s Community Health Investment
Corp., Detroit, MI
• Children’s Hospital of NJ, Newark, NJ
• HEALS, Inc., Huntsville, AL
Caring For Kids Dental Initiative
Project Goals
• Develop and expand dental services
within school-based health centers
• Increase access to dental care for
underserved populations
• Support the development of sustainable
school-based dental models
Grantee SBHC Overview
• Snapshot quarter: January – March 2004
• Number of schools: 17
• School enrollment: 13,087
•Median school enrollment: e.s. – 477, m.s. – 580
combined e.s./m.s. – 562; 1 h.s. – 4,296
• Demographic of school population
-- African Americans – 53%
-- Hispanics – 38%
-- Whites – 6%
-- Asians – 3%
-- Other – < 1%
Grantee SBHC Overview
• Average SBHC enrollment: 78% with health center
enrollment ranging from 25% to over 100%
• Clinic users: 4,703; All clinic visits: 10,617; Average
clinic visit: 758 Median clinic visits: 786
• Dental visits: 1,952 (18%)
• Average dental visits per site: 139
• Median dental visits per site: 124
• Dental visits by gender: 54% female, 46% male
High school: 63% female, 37% male
Dental Health Staffing
January – March 2004
Hours
Dentist
Dental
Hygienist
Dental
Assistant
> 35 hrs/wk
1
(ES)
1
(HS)
2
(1 ES, 1HS)
20 – 35 hrs/wk
1
(HS)
0
1
(1MS)
10 – 20 hrs/wk
5
(3 ES, 2 ES/Ms)
5
(4 ES, 1 MS)
5
(3 ES, 2 ES/Ms)
8
(4ES, 2MS, 2ES/MS)
5
(2ES, 1MS, 2
ES/MS)
7
(4 ES, 1MS, 2
ES/MS)
15
11
15
< 10 hrs/wk
Total
Dental Services by Students
Service
Exams/
Screenings
1,286
Percent
24
Routine X-Rays
Cleanings
Sealants
780
1,057
631
15
20
12
Fluoride
Treatments
Fillings
Root canals
1,041
20
400
14
8
.3
Crowns
Extractions
15
93
.3
2
No. of students
Caring for Kids
Dental Services Provided by Service Type
January - March 2004
Service -Procedure
X-Rays
Number
2,124
Percent
41
2,110
41
Extractions
141
3
Fillings
733
14
Root Canals
13
0.3
Crowns
18
0.4
5,139
100
Sealed Teeth
Totals
Health Insurance Status
January - March 2004
Payment Source
No. of Students (%)
Medicaid fee-forservice
Medicaid managed
care
1,089 (19)
SCHIP
189 (3)
Private Insurance
760 (13)
Uninsured/Self-pay
651 (11)
Missing Information
283 (5)
2,842 (49)
Patient Care Revenues
5 of 7 projects billed
Payment Source
Billed ($)
Collected (%)
Medicaid feefor-service
133,271
104,566 (78)
Medicaid
managed care
9,293
1,215 (13)
SCHIP
0
0
Private
Insurance
16,422
11,286 (69)
Uninsured/Selfpay
10,143
1,893 (19)
Totals
169,129
118,960 (70)
Caring for Kids Dental Health
Lessons Learned #1
• Partnering with community organizations is
key to start-up, staffing, and on-site clinical
and referral services
• Recruiting problems, staff turnover, recruiting
problems, and clinic delays reduced
productivity
• Patient care revenues can be generated
through third-party billing
Caring for Kids Dental Health
Lessons Learned #2
• Integrating medical and dental activities is
an important challenge to overcome
• System development is key to maximizing
efficiently of services – billing, appointment
procedures, quality assurance policy, and
MIS
Contact Information
The Center for
Health and Health Care in Schools
2121 K Street, NW Suite 250
Washington, DC 20036
Phone: 202-466-3396
Fax: 202-466-3467
Web Site: www.healthinschools.org
The Center for
Health and Health Care in Schools