1. Title V Oral Health Performance Measures John Rossetti, DDS, MPH Chief Dental Officer HRSA/MCHB

2. Title V - Critical to State Oral Health Programs Historically: Title V was the genesis for many programs Weakened by 1981 Block Grant OBRA ‘89 reversed program declines

3. Title V - Critical to State Oral Health Programs OBRA ‘89 required: Statewide needs assessment Plan development based on needs assessment & Year 2000 Health Objectives MCHB guidance for Block Grant

4. Sentinel Objectives (performance measures) From 6 Dental Objectives Submitted, 1 Would be Allowed: % of children receiving dental sealants

5. Dental Sealants as the Sentinel Objective: Rationale for Selection Elevate Medicaid’s awareness & raise fees Prevent occlusal decay in children Mechanism to screen and refer to private and safety net providers

6. Dental Sealants as Sentinel Objective: Rationale for Selection (cont.) Sensitize private sector to utilize sealants Integrate oral health into school health Build dental public health infrastructure

7. Dental Sealants as Sentinel Objective: Rationale for Selection (cont.) Increase collaboration between private and public sectors Build system of dental care for children Easily understood measure upon which everyone could agree

8. 1998 Block Grant Guidance Revision of Performance Measures Sealants selected as measure again States offered option to choose additional dental measures: Decrease disease through comprehensive prevention and education

9. 1998 Block Grant Guidance Revision of Performance Measures (cont.)  % of MA eligible children receiving dental services  prevalence of baby bottle tooth decay (BBTD)

10. 1998 Block Grant Guidance Revision of Performance Measures States offered option to choose additional dental measures - cont.:  awareness of BBTD causes  % of children with obvious tooth decay  % of Head Start children with tooth decay

11. How & What Have States Been Reporting 1997 - 11 States reported no sealant data 1998 - All States reported Utilization range: 1.2% - 56%