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Health Equity Forum: Oral Health Spotlight – March 2018
Alameda County Launches Pilot Program to Link More Residents to Oral Health Care
Alameda County is transforming the way children access dental care. Approximately 25 local county organizations are participating in a state funded Local Dental Pilot Project (LDPP). Part of the state’s 1115 waiver, or Medi-Cal 2020, the Dental Transformation Initiative (DTI) aims to increase the use of preventive dental services for children, prevent and treat more early childhood caries, and increase continuity of care for children. Improvements in dental care are critical to reducing disparities and achieving overall better health outcomes for Medi-Cal beneficiaries, particularly children.
"The Healthy Teeth, Healthy Communities” project in Alameda County has trained workers called “community dental care coordinators,” to connect families in Medi-Cal to oral health providers who are best able to serve them. The project seeks to develop a cross-system culturally and linguistically responsive care coordination workforce that represents the target population. Family preferences such as for bilingual providers, after-hours care and location are all taken into account to ensure children get the kind of culturally competent care their caregiver is seeking but may not have been connected to in the past. The coordinators are also administering surveys to better understand the types of barriers families face such as lack of transportation, housing or food that make it difficult to get to a dentist’s office in the first place before cavities develop. This information will be used to link families to other types of care such as primary or behavioral health care services.
“What’s exciting about this project is the relationships and the trust that’s being built between the partners,” notes Eileen Espejo, Senior Managing Director of Media and Health Policy with Children Now and also Chair of the Alameda County Oral Health Committee. “It doesn’t matter whose patient this individual is, or if they live outside the city line. It’s not about who belongs to which clinic but more like ‘let’s just get this patient the care and services they need,” Espejo says.
In February 2017, the Department of Health Care Services (DHCS) announced the 15 county entities whose proposals were selected for LDPP funding, with awards totaling $150 million over four years. The pilot projects, now in year 2 are one of the four domains of the DTI which represents a huge $740 million investment in the state’s Denti-Cal program. Alameda County’s dental pilot project is part of a multi-pronged approach that includes a dental community of practice component as well.
Espejo, who fell into this work initially through her focus on the harmful impacts of advertising to children, now provides technical assistance to counties throughout the state advising them on their local dental pilot projects and strategic plans. But she is especially proud of her work as a member of the Oral Health Committee in Alameda County which she now chairs.
“What’s remarkable about Alameda County’s [local pilot] that’s different than other counties was they were able to implement this new program much more quickly than the others because of the foundation they built over the years,” Espejo adds. Alameda County has a Dental Health Administrator, an Office of Oral Health and a strategic plan that they’re now in the process of updating, all of which provided a strong base that allowed the county to hit the ground running. “We already knew what needed to happen we just needed support to do it,” says Espejo.