Transcript Fluorides Committee

An Introduction to the
Federal Agencies and
Their Roles In Oral Health
Thursday, October 27, 2011
Hosted by the Association of State and
Territorial Dental Directors (ASTDD)
for New Member Orientation
Department of Health
and Human Services (HHS)
The U.S. government’s principal
agency for protecting the health
of all Americans and providing
essential human services,
especially for those who are least
able to help themselves.
HHS Organizational Chart
Administration for Children and
Families (ACF)
A federal agency funding state, territory, local and
tribal organizations to provide:
• family assistance
• child support
• child care
• Head Start/Early Head Start
• child welfare
• other programs relating to children and families
http://www.acf.hhs.gov/
Administration for Children,
Youth & Families (ACYF)
• Part of the Administration for Children and Families
• Administers the major Federal programs that
support social services that:
o Promote the positive growth and development of children
and youth and their families
o Provide protective services and shelter for those in at-risk
situations
o Promote adoption for children with special needs
Administration on Aging (AoA)
• Federal agency responsible for advancing the
concerns and interests of older people and their
caregivers
• Promote the development of a comprehensive and
coordinated system of home and communitybased long-term care that is responsive to the
needs and preferences of older people and their
family caregivers
http://www.aoa.gov/
Agency for Healthcare Research
and Quality (AHRQ)
• Improve the quality, safety, efficiency and
effectiveness of health care for all Americans
• Supports research that helps people make more
informed decisions and improve the quality of
health care services.
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National Guideline Clearinghouse - Clinical Practice Guidelines
Community Preventive Services Guide
U.S. Preventive Services Task Force
Evidence-Based Practice Centers
Medical Expenditure Panel Survey http://www.meps.ahrq.gov/mepsweb/
http://www.ahrq.org
Agency for Toxic Substances and
Disease Registry (ATSDR)
• Federal agency that serves the public by using the
best science, taking responsive public health
action, and providing trusted health information to
prevent harmful exposures and diseases related to
toxic substances
http://www.atsdr.cdc.gov/
Centers for Disease Control and
Prevention (CDC)
• Collaborate to create the expertise, information,
and tools that people and communities need to
protect their health – through health promotion,
prevention of disease, injury and disability, and
preparedness for new health threats
http://www.cdc.gov/
Centers for Disease Control
and Prevention (CDC)
• The lead federal agency for protecting health
and safety
• Providing credible information to enhance health
decisions
• Promoting health through strong partnerships
Oral Health
Vision and Mission
• Role: Provide national leadership to prevent and control
oral diseases and conditions and promote oral health.
• Vision: A nation where all people enjoy good oral health
that contributes to leading healthy, satisfying lives.
• Mission: Prevent and control oral diseases and
conditions and reduce disparities by building the
knowledge, tools, and networks that promote healthy
behaviors and effective public health practices and
programs.
Core Functions
• Monitor disease, risk factors, services
• Support public health research
• Communicate information to have an impact on
policy, practices, and programs
• Support implementation of interventions
• Build state capacity and infrastructure
• Evaluate programs to ensure success
• Facilitate partnerships to support priorities
Goals
• Prevent and control dental caries across the life
stages
• Prevent and control periodontal diseases
• Prevent and control oral and pharyngeal cancers
and their risk factors
• Eliminate disparities in oral health
• Promote prevention of disease transmission in
dental healthcare settings
• Increase state oral health program capacity and
effectiveness
Key Activities: Program Services Team
• Assists state health departments to build oral health
infrastructure and capacity
o Technical Assistance Workshops for funded states
o Listserve and Web board
• Tools and Resources:
http://www.cdc.gov/OralHealth/state_programs/
infrastructure/index.htm
• Web conferences to share lessons learned
• Annual Workshop for state dental directors
• Partnering with ASTDD (e.g. Best Practices project), Children’s
Dental Health Project, to develop resources for state programs
Key Activities: Program Services Team
• Fluoridation Technical Assistance
o Bi-annual training for fluoridation engineers and
state public health personnel
• CD Rom Training Program
o Engineering technical assistance
o Water Fluoridation Reporting System (WFRS)
o Assistance with responding to challenges to
fluoridation
Key Activities: Surveillance, Investigations,
and Research Team
• Collaborating with ASTDD on the National Oral
Health Surveillance System (NOHSS) and the
Synopses of State and Territorial Dental Public
Health Programs
www.cdc.gov/nohss
• Technical assistance on surveillance-related
questions, e.g., those related to centrally
coordinated data systems such as the
Behavioral Risk Factor Surveillance System
State Cooperative Agreements
• 20 states receiving approximately $6.8 million
over the next year
• $25 million over 5 years; awards range from
$235,000 to $355,000 per year
• Funded states (Alaska, Arkansas, Colorado,
Connecticut, Georgia, Kansas, Louisiana,
Maine, Maryland, Michigan, Minnesota,
Nevada, New York, North Dakota, Rhode
Island, South Carolina, Texas, Vermont,
Virginia, Wisconsin)
Key Components of
Infrastructure and Capacity
• Oral health program leadership
• Surveillance system to monitor oral diseases and
report on the burden of oral disease
• Strategic planning – state oral health plan
• State oral health coalition and strong partnerships
• Evidence-based programs – school-based dental
sealant programs and community water fluoridation
• Policy development and health systems strategies
• Collaboration with other chronic disease programs
• Program evaluation
CDC Oral Health
Program
http://www.cdc.gov/OralHealth
National Center for Health
Statistics (NCHS)
http://www.cdc.gov/nchs/
Centers for Medicare and Medicaid
Services (CMS)
• The Federal agency which administers Medicare,
Medicaid and the Children’s Health Insurance
Program
• Provides information for health professionals,
regional governments and consumers
http://www.cms.gov
Medicare
• Signed into law 1965 by President Johnson
• Health insurance program
o People age 65 and older
o People under age 65 with disabilities
o People of all ages with end-stage renal disease
• Medicare has
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Hospital insurance
Medical insurance
Prescription drug coverage ( added in 2006)
Does not include dental insurance
Medicaid
• Signed into law in 1965
• Health insurance available to certain low-income
individuals and families who fit into an eligibility
group that is recognized by federal and state law
• Medicaid is state administered and each state sets
its own guidelines regarding eligibility and services.
• State Medicaid Reports (CMS 416)
Medicaid Dental Coverage
• Dental services under Title XIX of the SSA are an
optional service for the adult population (age 21
and older)
• Required service for most Medicaid eligible under
21 as a required component of the EPSDT program
• Dental services must be provided at intervals that
meet reasonable standards of dental practice
• Periodicity schedules set by each state
• Services must include at a minimum, relief of pain
and infection, restoration of teeth and
maintenance of oral health
Children’s Health Insurance
Program (CHIP)
• SCHIP legislation passed in 1997
• CHIPRA legislation reauthorized in 2009
• Provides health insurance coverage to millions of
children who do not qualify for Medicaid-provides
grants to states to provide coverage for uninsured
children up to 200 percent of the federal poverty
level (ACA 2014 provision allows expansion to 300%)
• States can expand Medicaid or create a separate
program
CHIP Dental Coverage
• Includes coverage necessary to prevent disease
and promote health, restore oral structures to
health and function and treat emergency
conditions for all children up to age 19 who are
eligible
• States can choose to create a separate program
and offer one of four benefit options
• States can also use Title XXI funds for oral health
services initiatives (case management, OH
education, mobile dental units, etc.)
Food and Drug Administration
(FDA) http://www.fda.gov/
• Protects the public’s health by assuring the safety,
effectiveness, and security of human and veterinary
drugs, vaccines and other biological products,
medical devices, our nation’s food supply,
cosmetics, dietary supplements and products that
give off radiation
• Regulate tobacco products
• Advances the public health by helping to speed
innovations that make medicines more effective,
safer, and more affordable
• Helps the public get the accurate, science-based
information they need to use medicines and foods
Health Resources and Services
Administration (HRSA)
• The primary Federal agency for improving access to
health care services for people who are uninsured,
isolated or medically vulnerable
• Provides leadership and financial support to health
care providers in every state and territory
• HRSA grantees provide health care to the
uninsured, people living with HIV/AIDS, and
pregnant women, mothers and children
• Train health professionals and improve health
systems of care in rural communities
http://www.hrsa/gov
HRSA Goals
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Improve access to quality care and services
Strengthen the health workforce
Build healthy communities
Improve health equity
HRSA’s Oral Health Goals
• Improve infrastructure and systems of care
• Improve oral health status and outcomes to
eliminate disparities
• Improve the quality of oral health care
• Promote oral health by building public-private
partnerships
Bureau of Primary Health Care
(BPHC)
• Funds Health Centers in underserved communities,
providing access to high quality, family oriented,
comprehensive primary and preventive health care
for people who are low-income, uninsured or face
other obstacles to getting health care
• Delivers primary health care to patients, regardless
of their ability to pay, becoming the essential
provider for America’s uninsured. The nation's most
vulnerable populations -- people who are homeless,
migrant and seasonal farmworkers and residents of
public housing rely on the Health Center Program
for care
Maternal and Child Health Bureau
(MCHB)
• Administers the Maternal and Child Health Block
Grant to States and discretionary grants that ensure
that the Nation's women, infants, children,
adolescents, and their families, including fathers
and children with special health care needs, have
access to quality health care
• Administers discretionary grant programs that focus
on key issues in maternal and child health, support
research, and train maternal and child health
professionals
MCH Title V and Oral Health
Addresses access to quality oral health care for
children, including children with special health
care needs
• Supports a wide range of oral health activities
and initiatives via grants, contracts, and
cooperative and interagency agreements
• Supports rebuilding oral health program and
infrastructure at Federal, State and local levels
• Provides expertise and leadership to address oral
health needs of children in Head Start and Early
Head Start
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Bureau of Health Professions
• Increases the access to health care by developing,
distributing and retaining a diverse, culturally
competent health workforce
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Oral health workforce grants
Health professions training grants
Health workforce studies
Shortage designations
Children’s hospital graduate medical education
National Practitioner Data Bank/Healthcare Integrity and
Protection Data Bank
Healthcare Systems Bureau
• Protects the public health and promotes practices
that improve personal health, including organ,
bone marrow and cord blood donation
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Poison Control Program
Transplant Program
Drug Pricing Program
Injury Compensation Program
State Health Access program
HIV/AIDS Bureau
• Administers The Ryan White HIV/AIDS Program, the
largest Federal program focused exclusively on
HIV/AIDS care – for those who do not have sufficient
health care coverage or financial resources for
coping with HIV disease
• Majority of Ryan White funds support primary
medical care and essential support services
• A smaller portion funds technical assistance, clinical
training, and research on innovative models of care
• Part F provides funds for Special Projects of National
Significance, AIDS Education and Training Centers,
Dental Programs and the Minority AIDS Initiative
Bureau of Clinician Recruitment
and Service
• Helps underserved communities and facilities
experiencing critical shortages of health care
providers recruit and retain clinicians through
scholarship and educational loan repayment
opportunities in exchange for service
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National Health Service Corp
Various scholarship and loan repayment programs
J-1Visa and Visa Waiver program
Ambassador programs
National Maternal and Child Oral
Health Resource Center (OHRC)
• Supported by the Health
Resources and Services
Administration’s Maternal and
Child Health Bureau
• Address current and emerging
public oral health issues
• Collect, review, develop, and
share information and
materials
Georgetown University
Washington, DC
http://www.mchoralhealth.org
Indian Health Service (IHS)
• Is responsible for providing federal health services to
American Indians and Alaska Natives
• Is the principal federal health care provider and
health advocate for Indian people, and its goal is to
raise their health status to the highest possible level
http://www.ihs.gov
Indian Service Areas
A health care system
for the first Americans
• Raise the oral health status
of Indian people
• Provision of high quality
preventive treatment
services at community and
clinic level
• Program traditionally
oriented toward preventive
and basic care
National Institutes of Health (NIH)
• The nation’s medical research agency- support
scientific studies that turn discovery into health
• 27 Institutes
o National Institute of Dental and Craniofacial Research – provides
leadership for a national research program designed to understand, treat,
and ultimately prevent the infections and inherited craniofacial-oraldental diseases and disorders that compromise humans lives
o National Cancer Institute - the Federal government's principal agency for
cancer research and training
o Cancer Registries (SEER, state registries)
National Institutes of Health (NIH)
Resources
• NIH curriculum supplement for elementary schoolsOpen Wide and Trek Inside
• NIH Consensus Conference Statements
• Topic specific information for the public,
professionals, researchers
http://www.nidcr.nih.gov/
Office of the Inspector General
(OIG)
• Conducts audits, evaluations, investigations and
law enforcement efforts relating to HHS programs
and operations and provides recommendations
Substance Abuse and Mental
Health Services Administration
(SAMHSA)
• The agency works to reduce the impact of
substance abuse and mental illness on American
communities
• Provide national leadership in promoting the quality
and availability of behavioral health services
• Administers a combination of competitive, formula
and block grant programs and data collection
activities to support states, territories, tribes
communities and local organizations
Healthy People 2020
The “Big 3” for Direct Patient Care
Department of Justice
(DOJ)
• Federal Bureau of Prisons
o Provide oral health care to inmates
o Provide dental training programs
Department of Homeland Security
• U.S. Coast Guard
Department of Defense (DOD)
• The oldest and largest government agency
• The nation’s largest employer
• Provide military forces to deter war and protect the
security of our country
• Provide health care to the military branches (Navy,
Marines, Army, Air Force)
Contact Us
Association of State and Territorial Dental Directors
1838 Fieldcrest Drive
Sparks, NV 89434
Telephone: 775.626.5008
Fax: 775.626.9268