ORAL HEALTH INFRASTRUCTURE ORAL HEALTH INFRASTRUCTURE ENHANCEMENT FEASIBILITY ENHANCEMENT FEASIBILITY

ANALYSISANALYSIS

Project Update to DHCC Project Update to DHCC

November 5, 2009November 5, 2009

Source: John Snow, Inc. presentation to Steering Committee on August 3, 2009

Approach:Approach:

Phase I, II - completedPhase I, II - completed Phase III & IVPhase III & IV

Agree on most promising initiativesAgree on most promising initiatives

Develop detailed business and Develop detailed business and operational plans operational plans (Including identification of (Including identification of partners and collaborators)partners and collaborators)

Conduct feasibility assessment Conduct feasibility assessment (Sensitivity analysis and testing assumptions)(Sensitivity analysis and testing assumptions)

Final reporting and presentation Final reporting and presentation (Including written and oral presentation)(Including written and oral presentation)

Guiding PrinciplesGuiding Principles

Need for coordinated / systematic approachNeed for coordinated / systematic approach

Focus on most vulnerableFocus on most vulnerable

Pragmatic response that is inclusive of all Pragmatic response that is inclusive of all stakeholdersstakeholders

Builds capacity and strengthens workforceBuilds capacity and strengthens workforce

Involves the private sector overtimeInvolves the private sector overtime

Incorporates patient-centered approachIncorporates patient-centered approach

Aware of provider concerns and business realitiesAware of provider concerns and business realities

Update on Stakeholder Update on Stakeholder Interviews Interviews (examples…)(examples…)

Hospitals in Sussex CountyHospitals in Sussex County Private dentists in Sussex CountyPrivate dentists in Sussex County Delaware Dental SocietyDelaware Dental Society DIDER Board of DirectorsDIDER Board of Directors Dental Hygiene Clinic in Wilmington, DelTechDental Hygiene Clinic in Wilmington, DelTech State Medicaid Office State Medicaid Office La Red Health Center La Red Health Center Stockley Center Stockley Center Delaware Healthcare AssociationDelaware Healthcare Association

Preliminary Key Findings & Preliminary Key Findings & Draft RecommendationsDraft Recommendations

Multi-Purpose Clinic

Downstate Residency Program

Case Management Program

Multi-Purpose ClinicMulti-Purpose Clinic

Support Support La Red Community Health CenterLa Red Community Health Center (Designated FQHC) with its on-going efforts to (Designated FQHC) with its on-going efforts to develop primary care dental operationsdevelop primary care dental operations

Once up and running, La Red could work with Once up and running, La Red could work with various stakeholders to implement training various stakeholders to implement training activities starting in years 3 or 4activities starting in years 3 or 4– Community-based residency program in Community-based residency program in

collaboration with Sussex County hospitalscollaboration with Sussex County hospitals– Dental hygienist training site with DelTech Dental hygienist training site with DelTech

hygiene program students residents of Kent and hygiene program students residents of Kent and Sussex CountiesSussex Counties

– Dental assistant training site with Sussex County Dental assistant training site with Sussex County vocational schools vocational schools

Downstate Residency ProgramDownstate Residency Program

General Practice Residency sponsored by General Practice Residency sponsored by Sussex County hospital w/ community-Sussex County hospital w/ community-based clinical co-sponsorbased clinical co-sponsor– Bayhealth, Beebe, or Nanticoke Hospital would Bayhealth, Beebe, or Nanticoke Hospital would

be primary applicant (Could be collaborative be primary applicant (Could be collaborative effort between 2 or more hospitals)effort between 2 or more hospitals)

– La Red CHC would be clinical co-sponsorLa Red CHC would be clinical co-sponsor

– Wilmington-based GPR would play supportive Wilmington-based GPR would play supportive rolerole

– Sussex / Kent County private dentists and Sussex / Kent County private dentists and medical doctors would play supportive rolemedical doctors would play supportive role

Statewide Case Management Statewide Case Management ProgramProgram

Work with Work with La Red CHCLa Red CHC to case manage existing to case manage existing medical patients to obtain dental care.medical patients to obtain dental care.

Once established, work with the Public Health Once established, work with the Public Health Clinics, area schools, and other organizations (as Clinics, area schools, and other organizations (as appropriate) to case manage childrenappropriate) to case manage children– Coordinate respective outreach within area Coordinate respective outreach within area

schoolsschools– Collaborate to assist in providing treatment to Collaborate to assist in providing treatment to

high need children and facilitating a dental high need children and facilitating a dental home for ongoing preventive carehome for ongoing preventive care

Next StepsNext Steps Wrap-up and Finalize:Wrap-up and Finalize:

detailed business and operational plans detailed business and operational plans (Including identification of partners and collaborators)(Including identification of partners and collaborators)

feasibility assessment feasibility assessment (Sensitivity analysis and (Sensitivity analysis and testing assumptions)testing assumptions)

final report and presentation final report and presentation (DIDER, (DIDER, Steering Committee, & DHCC)Steering Committee, & DHCC) (Including written and oral presentation)(Including written and oral presentation)

Action –Action – Approve contract extension until Approve contract extension until May 30, 2010 to wrap-up project activities May 30, 2010 to wrap-up project activities and JSI presentation on recommendations and JSI presentation on recommendations and findings to DIDER Board (Dec) and and findings to DIDER Board (Dec) and DHCC (Feb)DHCC (Feb)