Ct Department of Public Health

CT DEPARTMENT OF PUBLIC HEALTH

Office of Oral Health

Home by One Advisory Committee

Meeting Summary February 24, 2010

10am-12pm

1. Introductions Dawn Senesac

Attendees: Tracey Andrews, Marjorie Chambers, Joanna Douglass, Felicia Epps, Anna Gorski, Lisa Honigfeld, Meghan Maloney, Linda Miklos, Marty Milkovic, Izabella Pulvermacher, Mary Jean Quistorff, Lisa Reynolds, Ben Rodriguez, Scott Selig, Dawn Senesac, and Fred Thal.

§ Mary Jean Quistorff RN was introduced and welcomed to committee.

2. Goal I: Information Exchange w/State Agencies/Communities Tracey Andrews

-Update on Objectives

v Year 3 plan so far: 3 meetings of Advisory

v Presentations since last meeting include:

o 12/1 Stepping Stones Museum, Norwalk Health Collaborative

o 12/4 The Resource Round Robin for Health Consultants at LEARN Old Lyme, CT.

§ Results: Asthma resource packet developed & Manchester RN connection invitation for Advisory

o 12/4 submitted Home by One Program as a best practice to be Association of Maternal & Child Health Programs (AMCHP)’s Best Practice Innovation Station

§ Result: accepted & Home by One is on AMCHP’s Innovation Station as of February 19, 2010

o 12/30 Training WIC of New Britain and Bristol

§ Resulting success story: Briarwood DH students connecting WIC clients to dental homes in New Britain, Newington and offering preventive services to parents without dental insurance.

o 1/5 Attended the medical care coordinators meeting

§ Result: contacted by Ped office in Litchfield who is implementing ABC program

o 1/11 Help me Grow sponsored HBO presentation to Community Breakfast in Bridgeport

§ Result: Southwest Community Health Center interested in training for medical providers.

o Contacted all 4 Dental Hygiene schools and set up Home by One Presentations which include motivational interviewing techniques with parents and caregivers as part of HBO Program sustainability to include age one curriculum in DH curriculum.

§ 1/27/10 Briarwood (15)students and 2/17/10 Fones(53)students completed.

§ Tunxis needs to be rescheduled due to snowstorm.

§ UNH is scheduled for April 5.

o 1/27 Help me Grow programs in Waterbury(1/27), Killingly(2/3) and Hartford(2/4).

o 2/4 Presented to Nutrition Managers in Head Start at Cavity Free refresher.

§ Success stories collaboration with Waterbury and CRT parent opportunities to promote Advocacy and education. PLTI in Meriden contacted me to see if available to speak to their group during the spring.

-Attending First Time Motherhood Initiative Meetings as well as quarterly MCH advisory meetings.

-Attending AMCHP conference on March 7 to present poster Home by One Program Building Integrated Partnerships with Connecticut Agencies, Parents and Providers

-Submitted Application for Samuel Harris grant to help sustain program and expand program.

-Promoting parent advocacy & oral health among parent work groups and family support network.

-Media update our banner was posted on Wall outside DAS in Hartford from 2-16-10 to 2-21-10

-Still need to have more dental representation on MCH advisory (Advisory: help identify dental providers or dental advocates candidates)

Advisory Comment

§ Marty and Izabella are interested in MCH Advisory

3. Goal II: Parents Trained as Advocates Tracey Andrews

-Update on Objectives.

§ Attending small parents groups and community breakfast groups & promoting advocacy idea resulting in invite to Putnam, Waterbury, and Hartford to present Advocacy & Oral Health Workshop.

§ East Hartford and Bridgeport will have presentations around breast-feeding events in August.

§ Torrington WIC collaborating with Brooker Memorial & offering dental care to pregnant moms and baby.

§ Tracey is trying to develop a List Serv of parent advocates from last year’s workshop evaluations.

Due to changes in COHI staff, COHI has been unable to provide us with contact information of parents that were trained last year, so haven’t been able to invite advocates to events, or contact regarding parent activities.

§ Tracey is collaborating with Family Support Network Tesha Imperati who has been awarded family scholar from AMCHP on helping her with oral health contacts for Family Support Network sponsored State Meeting with a forum focus on oral Health May 12, 2010 Cromwell Marriott or Crown Plaza.

-Care Specialists update Marty Milkovic

§ CT Dental Health Partnership – a lot of outreach going on with pregnant moms – hard time to reach them bad #’s 15% reachable 40-50% unreachable –

§ Mailings sent to 217,000 households that had not seen the dentist in one year, received 5000 responses

§ Do CDHP care specialists visit Physician offices?

Advisory Comments

-Lisa H. commented –– Joanna presenting at May 12 Family Support Network meeting

-Marty said CDHP would be interested in having a table at May 12 meeting

-Tracey mentioned good venue to have care specialists

-Joanna states that CT Dental Health Partnership is only one person that target population is hearing oral message from & the need is for more OBGYN and Practioners to mention oral health and need for dental exams during pregnancy

-Scott S.– Text for baby new program Community Health Center– OBGYN’s are using to educate especially reaching young Latino and African American/Black woman

-

-Scott S- cancer patients use a medical patient navigator model to advise screenings are essential and maybe oral health could utilize same type of navigator model to get patient’s connected to dental homes.

-Joanna stated Oral health is essential we need to educate the providers - physicians & pediatricians use AAPD & AAFP to reach physicians and care specialists can visit MD providing oral exams/fluoride varnishes in their regions.

-Care specialists can visit pediatrician offices and leave contact sheet with member services # to help pediatricians refer patients to dental homes

-Marge mentioned barriers to care include; transportation, child care

-WIC messages state how nutrition benefits the baby and moms listen. Maybe oral health messages stated as ways to benefit baby would work for Moms.

-Scott – APRN & doctors may be too busy. Maybe medical assistants need to be the venue to mention oral health in MD offices.

-Felicia –mentioned that a health message needs to be seen/heard 7 times before a person will act on it.

-Tracey – people may listen to MD’s, they trust what medical doctors say and are more used to

receiving health advice from them. Not as apt to listen to their dentist about health messages.

-MDs not implementing ABC program due to commercial insurance not covering

-Massachusetts & Maine have legislation in States – policy for age 1 visits for primary care doctors to get paid for dental exam and fluoride varnish by commercial insurance companies

-Marty says oral health messages are put in the Medicaid news bulletin 3x’s year and wants a Home by One message to put in.

-AAFP contact Joanna will get information for Marty to send information and contact Jill Woods AAP.

-Maine conference first tooth-Prompts were put into computer for medical providers to ask dental questions at age appropriate well baby visits

-Fred asked Marty about pregnant moms how does CDHP approach the moms about getting to dentist is there a list they go by?

4. Goal III: Expand Non-Dental Workforce Tracey Andrews

-Update on Objectives

-WIC sites

§ Trained 15 Bristol New Britain WIC staff 12/30 utilized new data questions for pre & post tests.

§ 3 WIC sites left to train and then complete. (Middletown, Yale and Hill Health)

-comments from WIC sites Marge Chambers, Kalpita Pradhan, Jackey Dieli

§ -Tracey invited to State WIC meeting March 12, opportunity to present update on HBO Program to all WIC staff

Physician training Update & Current billing data Dr. Joanna Douglass

§ 6800 kids got fluoride varnish done in 2009

§ 6000 billing fluoride only codes in 2009 – exam and education no code on data

§ Donna reviewed names of Pediatricians trained to see if any are billing, none so far.

Advisory Comments

-Joanna – Who are the Physicians that are doing fluoride only? Why are they not billing for oral risk assessment and education?

- Data at national level show very few physicians billing for fluoride varnish

-Joanna will help get the CT data questions settled

-Research needed-CT voices need to get data on how many physicians get patients to go to dentist.

-Joanna was asked, How many MDs trained at end of year 2? 395 – now about 420

-Linda Miklos - Torrington area – Outreach needed for EPIC has two big practices

5 . Goal IV: Dental Homes Tracey Andrews

-Update on Objectives

§ 4 more dentists added as (5) dental home sites 2 dental home sites in Fairfield, Hill Health, Derby and Woodbridge

§ 2 dentists scheduled for orientation, 1 large practice interested in scheduling June 2010 and

1 Pediatric dentist taking online course

§ Total Dental Homes to date: 26 dentists and 25 dental home sites, not including safety net sites like Brooker Memorial.

Course on CT Train results Meghan Maloney

-4 dentists have taken to date

-CSDA pilot home updates Scott Bialik/Doug Keck

Maine Conference Tracey Andrews

Medical Home update Mark Keenan

Family Support network Izabella Pulvermacher

-Forum ideas- CDC E-card shared with Advisory and attached to minutes below

Advisory Comments

-CDHA – March 3rd course The Age One Dental Home is cancelled.

-Joanna is trying to get physician training on CT TRAIN

-Smiles for life – Joanna getting on line training added to their site – modules will be added by June

-HBO website – resources website linked to UCONN will add Smiles for Life link.

-Izabella – get UCONN forms translated in Spanish – Pediatric in Spanish and English not adult

-Hygienists do not get CE on line so dentists want the live person for hygienist only can get CE’s by live person and we are waiting for CE regulation changes for dental hygienists to take effect (passed two years ago)

-Fred mentioned getting a referral from the dental hygiene students at New Britain WIC

-Fred Thal mentioned PEW article a lot of discussion in last 24 hours on this article.

-Tracey mentioned the two policy areas CT is lacking in are sealant programs in schools of high risk for dental disease and not having a primary/ mid level provider established

(Article and link are attached to minutes below)

-Lisa Reynolds – 5355 discussed raised bill for a pilot ADHP in Hartford area.

6.Other: New data Meghan Maloney / Tracey Andrews

-Web trend data

§ web trends used to monitor website; 51 hits on home by one page in January

-EPSDT discussion

§ Meghan presented 2008 CMS 416 ESPDT data as a Home by One Program data base line for children under Age 1 – receiving dental care – our state rankings do need some improvements

o For children age 1-2: CT ranked 34th/ out of 48 states with only 11.2% of eligible children receiving any dental care and 32nd out of 48 states with only 8.53% receiving preventive services

§ Tracey went over EPSDT Periodicity schedule with the advisory.

-Strategy for year four

o medical dental home model

- Discuss sustainability exercise results

Sustainability Exercise results discussed

o Linda Ferraro interview on radio station about early intervention disease prevention and promoting the Age one dental visit, was aired during month of February.

Advisory participation

-EPSDT not a good time to ask for changes due to fiscal climate of CT. Will keep in touch with DSS If medical gets updated then we can bring up dental updates. Joanna will monitor.

- Could ask CBIA to get on board with reimbursement to MDs for dental screening/fluoride varnish.

-Joanna –In a well child exam, eyes are part of the assessment why is dental not included?

-Anna Gorski –discussed how DDS went through Office of Policy Management to have discussions with Dept of Insurance to get on board with increase in rates. The insurance companies were willing to discuss with OPM and it resulted in a 10-20% increase

-Lisa Honigfeld – Commercial insurances do pay Developmental screenings

-Fred mentioned getting Age One dental visit into the dental schools curriculum and educating them on the Age 1.

-Give Home by One presentation to students in urban track program – UCONN students’ medical, dental and pharmacist combine to go out into communities of need of care. Investigate utilizing dental hygiene students in partnership with program.

-Suggestion to ask Robin Knowles what dental school/dental hygiene school collaboration exists in Hartford area currently

-Briarwood has been purchased by Lincoln College

7. Announcements /Next Meetings:

AMCHP conference March 6-10, Baltimore, MD

NOHC April 26-28 St. Louis, MO

Next meeting date: November 17, 2010

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