The John Muir/Mt. Diablo Community Health Fund has provided a $552,000 grant for the first of three years that will allow La Clínica to achieve momentum toward its goals. The grant supports direct delivery of an array of dental services and health education to sites in east and central Contra Costa that serve pregnant mothers, children ages 3-5, school age children from kindergarten through fifth grade, and seniors. It also supports needs assessment for seniors and planning, including the establishment of formal partnerships with locations where La Clínica will practice.
The Health Issue
Even prior to the recent economic downturn, there were significant disparities in access to dental care in Contra Costa, but due to state budget cuts, layoffs, the elimination of insurance and increased co-payments, the disparities have widened. The health of the entire community suffers when these disparities go unaddressed, because there are significant connections between poor oral health and everything from cardiovascular disease and poorly controlled diabetes to low birth weight babies and deteriorating quality of life. In addition, people without private dental insurance are seven times more likely to visit the emergency department, because they cannot address oral health problems in a timely way. Typically, the results are worse clinical outcomes and higher health care costs.
The Health Improvement Strategy
La Clínica's Oral Health Initiative builds on its existing dental services at its busy Monument and Pittsburg dental clinics, both of which recently added pediatric dentists. The new initiative targets those most affected by program cuts that range from the elimination of dental coverage under Medi-Cal to more restrictive eligibility requirements for other safety net programs. Low-income, uninsured or underinsured pregnant mothers, children ages 3-5, school age children from kindergarten through fifth grade, and seniors who have lost their dental insurance under Denti-Cal will all benefit.
Working closely with senior centers, teen clinics, public schools and Head Start centers, the program's centerpiece is the direct delivery of an array of dental services and health education to each of these sites. Visits begin with a community health educator and promotores delivering an oral health presentation on prevention. Dental professionals then offer treatments, with a strong focus on early and routine screening and care.
In addition to the dental services, a good portion of the first year has been spent on needs assessment and planning, so La Clínica can properly adapt the program in its final two years. As part of that process, La Clínica has been establishing formal partnerships with the locations where it intends to practice.
Working in partnership with outside evaluators Harder + Company Community Research, La Clínica and the CHF developed a three-year evaluation plan that began in January 2011. The plan focuses on:
- helping the partners understand and improve the implementation process,
- demonstrating the program’s effects on the oral health status of the targeted populations and
- exploring the sustainability of this model of service.