Health Resources and Services Administration- Oral Health Update American Association of Community Dental Programs Renée W. Joskow DDS, MPH Senior Dental Advisor April 17, 2016

Disclaimer The views expressed are solely the opinions of the author and do not necessarily reflect the official policies of the U.S. Department of Health and Human Services, or the Health Resources and Services Administration, nor does mention of the department or agency names imply endorsement by the U.S. Government 2

HRSA Mission 3 “To improve health and achieve health equity through access to quality services, a skilled health workforce and innovative programs.”

Objectives Describe HRSA’s agency mission or goals List two HRSA program areas with investment in oral health Identify a HRSA resource or report 4

Today’s Topics  Leadership and Organizational Update  Oral Health Program Updates  HRSA and HHS Oral Health Reports  Resources 5

Office of Strategic Initiatives OSI provides HRSA-wide leadership on the implementation of cross-agency initiatives, Departmental priorities, and emerging issues. In partnership with HRSA leadership, OSI identifies priority areas and implements a cross- agency strategy to maximize and streamline HRSA’s response and ultimately move the needle on emerging public health issues impacting the safety net. Health Resources and Services Administration 6

HRSA Strategic Goals 7

Improve Access to Quality Health Care and Services One in 3 people living at or below the poverty level relies on a HRSA-supported health center for primary medical care One in 2 people diagnosed with HIV receives care through the Ryan White HIV/AIDS Program 9.7 million people living in health professional shortage areas receive primary medical, dental or mental health care from a National Health Service Corps clinician 8

Improve Access to Quality Health Care and Services More than half of pregnant women and more than a third of infants and children benefit from maternal and child health block grants More than 700,000 rural Americans receive health services thanks to rural community-based grants About 115,500 parents and children participate in the national Home Visiting Program 9

Increasing Access to Primary Care Services 10

Improve Access to Quality Health Care and Services Health Centers 4.8 million patients served with nearly 12 million dental visits 27% increase in patients served since 2010 More than 12,800 dentists, hygienists, assistants, aides, techs Between 2013 and 2014 there was an Increase in preventive and restorative dental services and Decrease in emergency dental services 11

Improve Access to Quality Health Care and Services Nearly 1,000 New Access Points since 2009 Expanded Oral Health Services in 2014 and 2015 $93.9 million invested 325,000 additional patients receiving services More than 1,100 new dental providers FY 2016 Oral Health Expanded Services Funding Opportunity $150 million 12

Improve Access to Quality Health Care and Services  2015 UDS Clinical Quality Measure (Dental Sealant Measure)  Percentage of children, aged 6 through 9, at moderate to high risk for caries who received a sealant on a first permanent molar during the reporting period.  National Network for Oral Health Access Cooperative Agreement  Training and Technical Assistance for Expanding Access to Oral Health and Enhancing Quality Improvement 13

Federal Office of Rural Health Policy  State Offices of Rural Health Grant Program (SORH)  Rural Health Network Development Planning Program  Rural Health Care Services Outreach Program 14

Improving Maternal and Child Health 15

16 Select MCHB Initiatives  Maternal, Infant, and Early Childhood Home Visiting  Bright Futures early childhood-focused materials and tools  Bright Futures (new edition coming in 2016)  New periodicity schedule assures understanding of covered benefits  National Maternal and Child Oral Health Resource Center  Bright Futures Oral Health Toolbox  Bright Futures Pocket Guide (new edition coming in 2016)  Title V MCH Block Grant Oral Health Tool Kit

17 Investing in the Health Care Workforce

Increasing Access to HIV Care and Treatment 18

Ryan White HIV/AIDS Dental ProgramsHIV/AIDS BUREAU (HAB)  Dental Reimbursement Program  Community Based Dental Partnership 19

Strengthen the Health Workforce Ryan White HIV/AIDS Dental Programs  $3.5 million in Community Based Dental Partnership  $8.8 million in the Dental Reimbursement Program National Health Service Corps  1,300 dentists and dental hygienists Oral Health Training Programs - ~$36 million in FY 2016  Predoctoral & Postdoctoral training programs  State Oral Health Workforce Improvement 20

21 Integration of Oral Health and Primary Care

Recent Funding Opportunities 22  Title VII, Section 748: Pre-doctoral and post-doc grants, State Oral Health Workforce  Title VII, Section 747(b)(1)(A): Academic Unit - Primary Care Training and Enhancement  Title VII, Section 750 and 753(a); Title VIII, Section 865: Geriatric Workforce Education Program

HRSA RESOURCES 23

Integration of Oral Health and Primary Care  Oral health is an integral part of overall health and therefore, oral health care is an essential component of comprehensive health care.  Oral health promotion and disease prevention are essential to any strategies aimed at improving access to care. 24

HRSA Report gov/publichealth/ clinical/oralhealth/ primarycare/ integrationoforal health.pdf 25

HRSA Supported Publications 26  Considerations for Oral Health Integration in Primary Care Practice for Children primarycare.pdf  Oral Health Care During Pregnancy: A National Consensus Statement  Bright Futures in Practice: Oral Health—Pocket Guide (2nd ed.)  National Center for Health Workforce Analysis Dentists and Dental Hygienist Workforce Report projectionsdentists.pdf  The Role of Dental Hygienists in Providing Access to Oral Health Care pdf  Rural Oral Health Toolkit  National Conference of State Legislatures Oral Health Primer  National Academy for State Health Policy Oral Health Primer partnerships-a-primer-and-resource-guide-for-medicaid-agencies/

27 publichealth/clinical/ oralhealth/oralhealth factsheet.pdf

HHS Oral Health Strategic Framework 28

Guiding Principles 1.Oral disease is a health and health care problem and not solely a dental problem; 2.Long-term visibility of oral health in program and policy planning requires a comprehensive, deliberate, and innovative approach; and 3.HHS is a critical part of a larger oral health enterprise poised to implement the Framework’s goals though collaborative efforts to create collective impact 29

HHS OH Strategic Framework Goals Goal 1: Integrate Oral Health and Primary Health Care Goal 2: Prevent Disease and Promote Oral Health Goal 3: Increase Access to Oral Health Care and Eliminate Disparities Goal 4:Increase the Dissemination of Oral Health Information and Improve Health Literacy Goal 5: Advance Oral Health in Public Policy and Research 30

Contact Information Renée W. Joskow DDS, MPH Health Resources and Services Administration Senior Dental Advisor