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Children’s Oral Health Project: An Innovative Program for Improving Children’s Oral Health in Lake County. HEALTHY START. Children’s Oral Health Project. About Lake County, CA Project Goal. Project History, Partners and Funders School-based Project Services.
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Children’s Oral Health Project: An Innovative Program for Improving Children’s Oral Health in Lake County HEALTHY START
Children’s Oral Health Project • About Lake County, CA • Project Goal • Project History, Partners and Funders • School-based Project Services
Children’s Oral Health Project • Impact on Children's Oral Health • Elements of Project Success, Challenges and Opportunities • Impact on Systems of Care • Collaboration and Opportunities for Replicability
About Lake County, California Total Population: 65,000 76% White, 15% Hispanic/Latino, 3% Native American and 6% Multiracial/Other Rural County with about 52 people per square mile 30 miles from North to South end of Clear Lake County Seat: Lakeport Population = 5,000 Clearlake Population = 14,200 1999: Lakeside Health Center 2001: Lake County Tribal Health Clinic 2005: Clearlake Family Health Clinic
About Lake County, California • Unemployment Rate: 17% (Sept 2010) • Ranked 50th out of 58 counties in the State • Children living in Poverty: 28.4% • 67% of school-age children are enrolled in free and reduced price meal programs
About Lake County, California • Overall County Health Status Profile Ranked 52nd out of 58 counties in the State for all causes of death (CDPH 2010) • Children’s Oral Health Care 64% of children age 2-5 had never been to the dentist (CHIS 2003)
Project Goal: Improve Children’s Oral Health, targeting low income families through school-based services In California, an estimated 874,000 school days were missed because of dental-related illness. Students age 5 to 17 years missed an average of 1.7 days due to acute dental problems. Children whose family could not afford needed dental care missed more school days.
Project Goal: Improve Children’s Oral Health, targeting low-income families through school-based services Children who take a test while they have a toothache are unlikely to score as well as children who are undistracted by pain. Source: UCLA Health Policy Research Brief, Unaffordable Dental Care Is Linked to Frequent School Absences, N. Pourat and G. Nicholson, November 2009
Project History: What, When and Why? • 1980: State Funded Dental Disease Prevention Program began in Lake County schools through Public Health • 1994: LCOE Healthy Start Program began a holistic approach to education at Elementary Schools
Project History: What, When and Why? • 1998: No pediatric dentists in county, and no dentists accepting MediCal • 2000: First 5 Lake included children’s oral health among its identified needs with high priority • 2002: Children’s Oral Health Project begins in partnership with LCOE, First 5 Lake and Public Health
Current Project Partners Lake County Office of Education, Healthy Start Lake County Public Health, Children’s Dental Disease Prevention Clearlake Family Health Center Mark Cooper, DDS Lakeside Health Center (Lakeport) Doug Lewis, DDS Lake County Tribal Health First 5 Lake
First 5 Lake • Lake County Office of Education • ACCESS Dental, with grant from MRMIB/Healthy Families • Redbud Health Care District • California Department of Education • Lake County Wine Alliance • In-kind donations from Lake County Public Health Project Funders
School-Based Oral Health Services “When children’s oral health suffers, so does their ability to learn” (NMCOHRC, 2003) • The Lake County Children’s • Oral Health Project works with: • 7 School Districts, • including 13 school sites • 10 State funded and • private preschools, and • Migrant Head Start programs • Countywide Child Population 13,870 (Age Birth-18 years old)
Dental screening and fluoride varnishes at school sites by LCPH Dental Disease Prevention Program ACCESS Dental Van for treatment, including fluoride varnishes and sealants Lake County Children’s Oral Health 2002-2010 Major Project Services Dental chairs with block appointments at rural health clinics with decreased “no shows” Transportation from school to dental clinic appointments and to sedated dentistry
Other Project Services • Nutrition and oral health care education for preschool children and their parents • Case management for children with complex or severe dental treatment needs. • Partnership with Pediatric Dental Initiative (PDI), sedated dentistry program in Windsor • Follow-up with parents on the status of children’s oral health to assess long-term outcomes.
Over 16,480 dental screenings provided at school sites. Over 7,480 dental treatments provided. Over 2,900 sealants & varnishes provided at school sites. The Lake County Children’s Oral Health Project has provided sustained, consistent, and comprehensive services for 8 years. Over 700 children transported for multiple trips from school sites for dental appts.
Impact on Children’s Oral Health Increase in percentage of children screened who are caries free Project Outcomes
Impact on Children’s Oral Health Reduction in percentage of preschool children screened with Baby Bottle Tooth Decay Project Outcomes
Impact on Children’s Oral Health Reduction in Average Age of Child’s First Dental Visit at Lakeside Health Center, Dental Clinic 2008 5.9 years 2009 5.3 years 2010 4.4 years Project Outcomes
Impact on Children’s Oral Health Results of Kindergarten Proof of Dental Assessment Project Outcomes
Elements of Project Success • Project originally driven by staff working “on the ground”. • Utilized unique skills and talents of existing staff in Public Health and Healthy Start. • Strong support and involvement of school administration and teachers in meeting the oral health needs of their students. Project Success
Elements of Project Success • Strong collaborative approach and community focus by First 5 Lake, Healthy Start, Public Health and local dental clinics. • Sustained, consistent staffing and funding across extended period of time. • More dental insurance outreach and enrollment. • Growth in clinic-based dental services. Project Success
Elements of Project Success • 1999: Lakeside Health Center (Lakeport) opens with 7 dental chairs • 2001: Lake County Tribal Health (Lakeport) opened with 5 dental chairs • 2004: Lakeside Health Center expands capacity to 10 dental chairs • 2005: Clearlake Family Health Clinic opened dental clinic with 4 chairs • 2008: PDI opened, serving Lake County children with sedated dentistry needs • 2010: LCTHC opens newly remodeled clinic with 12 chairs Project Success
Current Program Challenges & Opportunities • Funding, funding, funding • Sustained staffing • School-based health needs Project Success
Impact on Integrated Systems of Care • Developed community and school-based connections for outreach to build awareness of oral health issues and prevent dental disease. • Embedded focus on children’s oral health as part of all health care delivery. • Developed 8-year set of data on the status of children’s oral health for planning and evaluation Project Outcomes
Impact on Integrated Systems of Care • Created local Oral Health Access Council (OHAC) to support collaboration and communication, and to bring local dentists to the table. • Developed 4-year Oral Health Strategic Plan for the County. • Identified and taken advantage of opportunities to advocate for increased access to care and awareness of children’s oral health issues at state and national level Project Outcomes
For more information, contact: Joan Reynolds, MSW, Lake County Office of Education, (707) 262-4146, jreynolds@lakecoe.org Marta Fuller, RN, Lake County Public Health, (707) 263-1090,martaf@co.lake.ca.us Cathy Ferron, MBA, Ferron & Associates, Planning & Evaluation Consultants, (415) 453-5647, caferronassoc@comcast.net