p3Dental SolutionsLEAN SIX SIGMA CONSULTING

Productivity. Performance. Proficiency.

Oral Health Service Expansion Grants

Kentucky Primary Care Association

October 19th, 2010

p3 Dental Solutions

Expanding Oral Healthcare Access

In Kentucky

AGENDA

HRSAs Office of Strategic Priorities The Executive Summary Responding to Guidance Selection Process

Need Response Evaluative Measures Impact Resources/Capabilities Support Requested

Resource Contacts

FQHC Health Center, 2002 – 2007 Unduplicated Dental Patients

1,644,9171,885,359

2,150,6642,340,710

2,557,0032,808,418

0

500,000

1,000,000

1,500,000

2,000,000

2,500,000

3,000,000

2002 2003 2004 2005 2006 2007

Year

Den

tal P

atie

nts

Data Source: HRSA/BPHC Uniform Data System, 2002 – 2007

HRSAs Office of Strategic Priorities

Existing and Expanding FQHC Sites

HRSAs Office of Strategic Priorities

Health Centers Onsite Preventive Dental Services

Data Source: HRSA/BPHC Uniform Data System, 2002 - 2007

HRSAs Office of Strategic Priorities

The Executive Summary

Date of Release: November, 2009

HRSA Targeted $7.5 Million

HRSA Expects to Award Approximately 30 Grants Totaling $7.5 Million to Increase Access to Oral Health Services by Establishing or Expanding Oral Health Services.

The Executive Summary Grants will not exceed $250,000 per year in both Year 1 and 2

Applicants may propose to provide Oral Health services onsite

or through a contractual arrangement to provide services at an

off-site location, new site or expand their sites.

Oral Health Service Expansion is not an opportunity to request

financial support to serve a different target population

Available to the following: Community Health Centers (CHC) – section 330(e) Migrant Health Centers (MHC) – section 330(g) Health Care for the Homeless (HCH) – section 330(h) Public Housing Primary Care (PHPC) – section 330(i)

Responding to the Guidance

Tell Your Story

• Use Jeopardy Answers

• Be Specific

• Answer Every Question, Even Twice

• Have Reliable Data

Selection Process

• Division of Independent Review

• Score Adjustments

• Preferences

• Other Factors

Scoring of Your Application

Selection ProcessApplication Criteria

Applicants should organize the program narrative using the following six section headers: CRTIERION 1: NEED (15 POINTS) CRITERION 2: RESPONSE (35 POINTS) CRITERION 3: EVALUATIVE MEASURES (10 POINTS) CRITERION 4: IMPACT (10 POINTS) CRITERION 5: RESOURCES/CAPABILITIES (20 POINTS) CRITERION 6: SUPPORT REQUESTED (10 POINTS) 

Need(15 Points)

1. Service Area DescriptionA. Type of AreaB. Dental Health Professional Shortage Area (DHPSA)

2. Target PopulationA. Unique Demographic CharacteristicsB. Special PopulationsC. Oral Health Status

3. Identification of Patient and Visits that Will Receive Oral Health Services

Need

4. Oral Health Service ProvidersA. Significant Barriers and Gaps in ServicesB. Behavioral Health-Related Issues

5. Understanding of the Health Care EnvironmentA. State Reimbursement EnvironmentB. Barriers or Problems with Reimbursement

Need

Avoid “Statements of Generalities” in Your Need Findings

• “There is Great Need to Serve More than 10,000 Low-Income Uninsured Residents in the Southern Berkshire Region”

• “Additional Medical Personnel who Focus on Primary Care are Needed.”

• “More than 80% of these Low-Income Uninsured Respondents are Willing to Use a New Free Clinic”

Need

Dental Safety Net Populations Assessment

• Review of Federal and State Data Existing Health Care Research

• Commissioned Expert Demographic Analysis of US Census Data

• Interview of Health Care Providers and Community Leaders

• Survey of Allied Community Resources about Unmet Medical Needs

RESPONSE (35 POINTS)

1. Applicant ‘s Proposed Plan of Expansion or Establishment

A. Provide Oral Health Care ServicesB. Location of Site C. Dental Lab Arrangements

2. Appropriateness of ArrangementsA. Linkages, Collaborations, PartnershipsB. Service Contracts

3. Informing the Target Population of Services (Marketing of Services, namely Prevention, Intervention and Education

4. How Oral Health will be Integrated with the Health Center’s Primary Health Care Services

5. How Oral Health Services will Account for Needs of the Cultural and Linguistically Diverse Patients

RESPONSE

6. Off-Site Referrals

7. Special Populations

8. Proposed Staffing

9. Recruitment

10. Project Management A. Up and Running in 120 days

11.Plan for Long-Term Viability

.

RESPONSE

RESPONSE

12. Proposed Quality Improvement Plan

13. Tracking Oral Health Care Patients

EVALUATIVE MEASURES (10 POINTS)

1. Identify Performance MeasuresA. Healthcare B. Business Plan

2. Performance Impact to the Overall Healthcare Center

3. Tracking Patient Treatment Outcomes Overtime

EVALUATIVE MEASURES (10 POINTS)

4. Performance Implementation ProtocolA. Goals and Data Collection

Practice Metrics

Gross Charges *Number of Sliding Fee Patients

Net Revenue *Number of Fee For Services Patients

Expenses (Direct and Indirect) Average Patients Seen/Day

Total Number of Visits *Clinical Hours per Day/Month

Revenue per visit No-Show Rate

Cost per visit # of Emergency Patients

*Number of Transactions (by ADA Code) # of Work-In Patients

*Number of Completed Patients *Total # of Clinical Days Practice

*Number of New Patients *# of Days at Full Clinical Operations

Number of Unduplicated Patients *Days to Next Patient Appointment

Number of Hygiene Recall Patients *# of Billable vs. Non-Billable Visits

*Number of Medicaid Patients Dental Supplies (Monthly)

1. CHC Demonstrated Experience and Expertise in Providing Services

A. Working with Target Population

B. Addressing the Needs of Target Population

C. Developing Appropriate Community Systems and Services

D. Community Collaboratives

IMPACT (10 POINTS)

IMPACT

2. How the Applicant Organization Will Reduce or Eliminate Existing Barriers and Increase Access to Oral Healthcare

3. Formal and Informal Collaborations with other Healthcare Institutions, FQHC, FQHC-Look Alikes and Community-Based Centers

COMMUNITIESOF DENTAL

NEED

Within a Community of Need

Head Start

Pilot Program2008

Students

Screened60

Total # of Patients

In Treatment

48

# of Areas of Decay

240

Total Cases

Completed31

City of York

School Sealant Program

2008

Students

Screened286

Sealants Placed 893

% Untreated Decay

42.8%

Urgent Dental Referrals Made

25

IMPACT

RESOURCES/CAPABILITIES(20 POINTS)

1. Location of the Oral Health CenterA. Existing Healthcare Program ServicesB. Availability and Accessibility of Space For an Oral Health Center

2. Current Programs Assets to Support DevelopmentA. Site Map and Floor PlanB. Relation to Existing Service Centers

RESOURCES/CAPABILITIES

3. Support and Commitment from Key StakeholdersA. Internal-

i. Executive Boardii. Executive Directoriii. Core Management

B. External-i. Healthcare Resourcesii. Community, Partnersiii. Other Government Programs

SUPPORT REQUESTED(10 POINTS)

1. BudgetA. Level of funds; total resources

necessary

B. Maximization of non-grant revenue

C. Users/encounter data; productivity

D. Patient care income

E. Cost/user/encounter

F. Total dollars/user

HRSA Averages and Recommendations (UDS ‘05)

Practice Metrics Benchmark Averages

Productivity Days/Yr(Hours/Yr)

200 work days(net 1600 hrs)

Patients/Hr 1.6

Number Patient Visits/Patient 2.2

Unduplicated Patients 1,000

Total Revenue Generated /FTE Dentist $300,000

Total Revenue/Visit $117

Encounters/FTE Dentist 2564

Encounters/FTE Hygienist 1600

# of Dental Operatories (Chairs) 2

# of Dental Assistants 1.5

SUPPORT REQUESTED

SUPPORT REQUESTED

SUPPORT REQUESTED

2) Rationale for New Equipment

3) Cost of Non-Reimbursement Services

4) Leverage of Federal Funds

5) Cost-Effectiveness

Resources

http://www.dentalclinicmanual.com/

Expanding Access to Dental Care ThroughCalifornia’s Community Health Centers

www.chcf.org/resources/download.aspx?id=%7B2F0B8A3C-D0B2...

Growing and Sustaining a Dental Clinic within the Primary Care “Safety Net”

www.mchoralhealth.org/presentations/NOHPC2006/S_Russell.pdf

Forms, Forms, and More Forms The program-specific forms are located in Grants.gov   BPHC program-specific forms 1A, 1B, 2, 3, 5A.5B and 12 must be included: Form 1: General Information Worksheet and BPHC Funding Request

Summary Form 2: Staffing Profile Form 3: Income Analysis Format for Years 1 and 2 Form 5A: This form needs to be completed for the proposed changes in the

mode of service delivery for the specific service expansion category. Form 5B: This form needs to be completed only if the applicant organization

is proposing to serve a new service area.

Resource Contacts

Jay Anderson, DMD,MHSAChief Dental Officer

Health Resources and Services Administration

5600 Fishers Lane, Room 6C-26

Rockville, MD 20857

Phone: 301-594-4295

Fax: 301-443-7853

Email: JAnderson@hrsa.gov

 

Resource Contacts

Tiffani Redding

Public Health Analyst

Bureau of Primary Health Care

Office of Policy and Program Development

Telephone: 301/594-4300

Fax: 301/480-7225

Email: TRedding@hrsa.gov

Technical Assistance Resources: www.hrsa.gov/grants/technicalassistance/sexp.htm

p3Dental Solutions, LLC5405 Tuckerman LaneSuite 910Rockville, MD 20852

W: 240-330-6226

info@p3dental.comjamespatsis@hotmail.comwww.p3dental.com

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