Dental Health Foundation Update Wynne Grossman Executive Director October 23, 2006

Dental Health Foundation Activities  Needs Assessment Follow-up  Policy Work  Citizens Dialogues on Water Fluoridation  First 5 Oral Health Initiative

Needs Assessment Recommendations 1.Develop a comprehensive surveillance system with:  Local (county) assessments  Statewide assessments every five years 2. Eliminate Barriers to Care  Support the inclusion of dental coverage in all insurance proposal.  Expand programs to inform Medi-Cal, Healthy Families and Children’s Health Initiative enrollees about their dental benefits  Provide financial incentives to medical and dental professionals to provide early preventive care  Increase payments for preventive services

Needs Assessment Recommendations, cont. 3.Prevent Disease  Every child to have a dental examination and necessary treatment by kindergarten.  Require all dental insurance to provide coverage for dental sealants and other preventive measures.  Increase the number of preschool children served by existing programs that receive fluoride varnish applications  Increase funding for State prevention programs  add more schools, more grades, special education programs  Fund dental sealant programs and other preventive services  Conduct a sealant promotion campaign directed at both the public and dental professionals.

Needs Assessment Recommendations, cont. 3.Prevent disease, cont.  Increase financial support for capital and operations of community water fluoridation.  Build the science base by encouraging more research aimed at prevention and elimination of the disease 4.Establish an Integrated Public Health Infrastructure  Require California to create and maintain a state dental director position.  Grow the public dental health workforce.

Needs Assessment Release  7 Press Conferences covering the entire state (February 6 th )  Sacramento (Robyn Keller/Kate Varanelli)  Los Angeles  Oakland (Jo Kerner)  Fresno (Rosemarie Amaral)  Santa Cruz (Natasha Kowalski)  San Diego  Humboldt County (Laura McElwen)  Coverage in most newspapers, television and radio stations  Editorials in LA Times, Oakland Tribune, Contra Costa Times

Policy Work  OHAC and various organizations support recommendations in report  Visits to Legislative staff and members to discuss findings and possible solutions  Legislative dinner with potential oral health champions (February 27 th )  Informational Hearing on Children’s Oral Health before the Assembly Health Committee (February 28 th )  Legislative tour in Alameda County (July)  Visits to presumptive members to educate them about oral health activities

Policy Work  Sponsored Legislation  Budget item Dental Disease Prevention Program Bill AB 3071 (Chan)  Strengthen CDDPP by adding an advisory committee, an evaluation component and requiring evidence-based and age appropriate interventions  Weakened bill passed legislature  Governor did not have a chance to take action  Pulled back by author

Policy Work  Dental Disease Prevention Program Budget Item 4260  Increased budget allocation by $5.5 million. Intent was to increase both per child allocation and number of participating schools  Budget item was reduced to $2 million  Primary opposition was DHS  Passed by Legislature  Vetoed by Governor Veto Message “ I am deleting the $2,000,000 legislative augmentation for the California Children’s Dental Disease Program (CDDPP). With this reduction, $3,300,000 still remains to support 33 programs statewide, serving over 1,200 schools and 326,000 children. In addition, this budget includes $1,500,000 in the Medi-Cal and $500,000 in the Healthy Families programs for dental services related to my proposal to ensure dental screenings are available for California's school children.”

Policy Work DHF Policy Agenda (2007) Leading Issues:  CDDPP:  Initiate enhancements to the program and increase funding to improve services and add schools  Dental Director:  Require California to create and maintain a state dental director position  Healthy Kids Healthy Teeth Expansion:  Develop a pilot program to expand this demonstration project in multiple counties. The project includes financial incentives to medical and dental professionals to provide early preventive care and case management.  CHDP Requirement:  Require CHDP medical providers to refer children to a dentist by age 1. This is currently a recommendation.

Policy Work, cont. DHF Policy Agenda (2007), cont. Issues to Support:  Collect and report on dental practice information: e.g. FTE, % of public insurance in practice, race/ethnicity  Tobacco Tax Initiative (Prop 86)  Collect and report on the oral health status of seniors

Citizen Dialogues on Community Water Fluoridation  Three year research project  Conducted by  Dental Health Foundation  Viewpoint Learning  Sponsored by  Centers for Disease Control and Prevention

Project goals 1. To determine:  Which considerations are most important in forming and changing San Diegan’s views on fluoridation  How citizens’ interactions with each other shape their decision on the issue  How average citizens receive information, process it, form their attitudes on fluoridation and decide how they intend to vote 2. To lay the groundwork for future efforts to engage the broader community and educate the public 3. To develop insight into how the public reaches judgment on policy issues with a strong scientific component

Dialogues on Water Fluoridation in San Diego  June 2005: Three dialogues  Sept/October 2006: Three follow-up dialogues (revised materials)  Morning  Crafting a vision of oral health in San Diego  Determining trade-offs  Afternoon  Testing vision by examining pro and con fluoridation materials (the type that would be used in a campaign)

Do not fluoridate Fluoridate Do not fluoridate Fluoridate General outcomes in 2005 : Initial/Final opinions Initial opinionsFinal opinions Scenarios rated on a 1-10 scale, 10 being best

Thinking it through Preserve individual choice wherever possible ? WHAT TO DO WITH LF ? IS CWF EFFECTIVE, SAFE, BENEFICIAL ? We need more evidence …IF CWF is effective, safe, and beneficial to the wider community Individual choice should take a back seat… Mistrust Technical evidence can be spun Existing strong opinion? No change in opinion yes Do nothing -- Better safe than sorry no Rely on “common sense”

First 5 Oral Health Initiative  Consumer education  Distributed 900,000 brochures throughout state  Conduct 7 regional trainings for WIC and Head Start per year  Online clearninghouse  On-demand training for medical and dental providers  One web-cast completed, 2 planned for next six months  140,00 visitors to date

Providers Trained through August g oalReached Dentists5, Dental Hygienists 2, Dental Assistants 5, Physicians2, Residents Nurse practitioners