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OUR CURRENT REALITY
Upper Peninsula Children’s Oral Health Summit
NMU Conference Center
May 17, 2014
--Kayla West, MBA
Alger
Barag
a
Chipp
ewa
Delta
Dickin
son
Gogeb
ic
Hough
ton
Iron
Kewee
naw
Luce
Mac
kinac
Mar
quet
te
Men
omin
ee
Onton
agon
Schoo
lcraf
t -
500
1,000
1,500
2,000
2,500
3,000
Dental Visits in 2012--Medicaid Children Ages 0-4
Total Eligible1 or More Visits
Alger
Barag
a
Chipp
ewa
Delta
Dickin
son
Gogeb
ic
Hough
ton
Iron
Kewee
naw
Luce
Mac
kinac
Mar
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Men
omin
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Onton
agon
Schoo
lcraf
t0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Dental Visits in 2012--Medicaid Children Ages 0-4
No Visits1 or More Visits
Alger
Barag
a
Chipp
ewa
Delta
Dickin
son
Gogeb
ic
Hough
ton
Iron
Kewee
naw
Luce
Mac
kinac
Mar
quet
te
Men
omin
ee
Onton
agon
Schoo
lcraf
t -
500
1,000
1,500
2,000
2,500
3,000
Dental Visits in 2012--Medicaid Children Ages 5-14
Total Eligible1 or More Visits
Alger
Barag
a
Chipp
ewa
Delta
Dickin
son
Gogeb
ic
Hough
ton
Iron
Kewee
naw
Luce
Mac
kinac
Mar
quet
te
Men
omin
ee
Onton
agon
Schoo
lcraf
t0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Dental Visits in 2012--Medicaid Children Ages 5-14
No Visits1 or More Visits
Alger
Barag
a
Chipp
ewa
Delta
Dickin
son
Gogeb
ic
Hough
ton
Iron
Kewee
naw
Luce
Mac
kinac
Mar
quet
te
Men
omin
ee
Onton
agon
Schoo
lcraf
t -
500
1,000
1,500
2,000
2,500
3,000
Dental Visits in 2012--Medicaid Children Ages 15-20
Total Eligible1 or More Visits
Alger
Barag
a
Chipp
ewa
Delta
Dickin
son
Gogeb
ic
Hough
ton
Iron
Kewee
naw
Luce
Mac
kinac
Mar
quet
te
Men
omin
ee
Onton
agon
Schoo
lcraf
t0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Dental Visits in 2012--Medicaid Children Ages 15-20
No Visits1 or More Visits
Alger
Barag
a
Chipp
ewa
Delta
Dickin
son
Gogeb
ic
Hough
ton
Iron
Kewee
naw
Luce
Mac
kinac
Mar
quet
te
Men
omin
ee
Onton
agon
Schoo
lcraf
t -
500
1,000
1,500
2,000
2,500
3,000
Dental Visits in 2012—Medicaid Adults Age 21-60
Total Eligible1 or More Visits
Alger
Barag
a
Chipp
ewa
Delta
Dickin
son
Gogeb
ic
Hough
ton
Iron
Kewee
naw
Luce
Mac
kinac
Mar
quet
te
Men
omin
ee
Onton
agon
Schoo
lcraf
t0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Dental Visits in 2012—Medicaid Adults Age 21-60
No Visits1 or More Visits
0%
10%
20%
30%
40%
50%
60%
70%
80%
Household Income Correlated With Health Status and Access To Care
(WUP CHNA)$0 - $24,999
$25,000 - $49,999
$50,000 or more
Western UP Overall
• Coverage & Financing
• Safety Net
• Workforce
• Prevention
• Surveillance
5 Buckets
Focusing on “Systems”
Remember the 1980’s—Haven’t we been here before?
• 2000 US--Former Surgeon General David Satcher’s “Silent Epidemic”• 2000 SOM--Healthy Kids Dental for Medicaid Children (22 counties)• 2000 SOM—Community Dental Clinics North – 21 counties• 2000 SOM—4th Year Dental Student Externships• State Office of Oral Health
• Fluoride Equipment Grants• Varnish! Michigan, Varnish! Michigan – Babies Too!• SEAL! Michigan
• 2003 SOM—Michigan Oral Health Coalition• 2004 Michigan Community Dental Clinics, Inc.• 2012 US—Affordable Care Act• 2014 SOM—Medicaid Expansion With Adult Dental Benefits
Driving Distances – 30 Minute
Radius
Distribution of Safety Net Dental Clinics
Uninsured adults only
Which Safety Net Dental Clinics Will See Children in 2015?
Dr. Brian Anderson--Hospital Cases (10/12 – 4/14)
Number of Cases by Year Number of Cases by Age
1 2 3 4 5 6 7 8 9 10 11 120
2
4
6
8
10
12
14
16
18
10
5
10
15
20
25
30
35
40
45
2011 2012 2013 2014
Distribution of Hospital Cases for Children
Hospital Cases—Dr. Brian Anderson
$ Billed vs. $ Reimbursed Billed vs. % Reimbursed
1 6 11 16 21 26 31 36 41 46 51 56 61 66 71$0
$1,000
$2,000
$3,000
$4,000
$5,000
$6,000
$7,000
1 6 11 16 21 26 31 36 41 46 51 56 61 66 710.00%
10.00%
20.00%
30.00%
40.00%
50.00%
60.00%
70.00%
80.00%
90.00%
100.00%
% Reimbursed
Fluoridation of community water supplies is “One of the greatest public health advances of the last century.” (Centers for Disease Control and Prevention) 33% of the UP population
has access to fluoridated community water systems.
Sources: Kayla West (Oral Health for All Coalition). Map by Eric Anderson, PHD, Senior Planner, County of Marquette Data from John Clark, DEQ.
Do Health Departments Apply Fluoride Varnish in
MIHP and WIC Programs?
Yes
Yes
Yes
Marquette County, Pop. 67,906 (2012)
FRL = Free/Reduced Lunch
• Community Water System With Fluoride
• Community Water System No Fluoride
Marquette**Cherry Creek = 378,
27% FRLVandenboom = 20,
10% FRLSandy Knoll = 376,
38% FRLSuperior Hills = 294,
27% FRLGravereat = 122,
46% FRLMiddle = 860,
29% FRLHigh School = 1042,
38% FRLNorth Star = 271,
62% FRL RESA = 60 42% FR Total Students: 3,423
PowellK-8 = 46, 52% FRL
Ishpeming Birchview = 310, 55% FRLMiddle = 254, 48% FRLHigh School = 266, 36% FRL
Total Students: 830
Republic-MichigammeK-12 = 136,
63% FRL
WellsK-8 = 12, 75% FRL
Gwinn Sawyer
West Ishpeming, NICE
Aspin Ridge = 823, 32% FRLWestwood = 345, 19% FRLTotal Students: 1,168
Sawyer Elem = 285 , 87% FRLGwinn Elem = 263, 59% FRLMiddle = 262, 70% FRLHigh = 386, 51% FRLTotal Student Pop. = 1,196
Negaunee Lakeview = 738, 33% FRLMiddle = 326, 32% FRLHigh School = 421, 30% FRL Total Students: 1,485
I’m sure glad the hole isn’t in our end…..
Source: Russell Ackoff (http://www.youtube.com/watch?v=UdBiXbuD1h4)
END OF OVERVIEW
LUCE COUNTYCase Study of a “Positive Deviant”
Iron
Men
omine
e
Kewee
naw
Alger
Hough
ton
Gogeb
ic
Mac
kinac
Delta
Dickins
on
Chippe
wa
Mar
quet
te
Schoo
lcraf
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Barag
a
Onton
agon
Luce
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
What Percentage of Healthy Kids Dental Children, Ages 0-4, In Each County, Had At Least One Dental Visit in 2012?
With 1+ Dental Visits in Past Year Without Dental Visit in Past Year
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