“Using a Public-Private Partnership to Create/Expand a ... · located in Falls Church, VA, has been caring for patients since 1994. Inspired by private practicing dentists, it is

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Field Report: Northern Virginia Dental Clinic

“Using a Public-Private Partnership toCreate/Expand a Volunteer Dental Project”

A report written by organizers of volunteer-basedhealth care programs serving the uninsured.

Field ReportField Report


Field Report

Northern Virginia Dental Clinic

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PROJECT DESCRIPTION ...................................................................... 3

Services Rendered ...................................................................................................3

Current # Professional Volunteers ....................................................................3

Current # Other Volunteers .................................................................................3

Current # Paid Staff .................................................................................................4

Patient Profile & Eligibility Criteria ......................................................................4

Hours & Days of Operation ..................................................................................4

Funding Sources .......................................................................................................4

The Value of a Public- Private Partnership .....................................................4

FIRST STEPS .......................................................................................... 5

Inspiration ....................................................................................................................5

Initial Plans ..................................................................................................................5

The Partnership Takes Shape ..............................................................................5

Why Was a Public-Private Partnership Preferable .......................................5

CONVENING THE PARTNERSHIP ...................................................... 6

The Public and Private Sectors Come Together ...........................................6

Documenting the Need .........................................................................................6

Harmonious Discussions .......................................................................................6

Bricks and Mortar .....................................................................................................6

SUSTAINING THE PARTNERSHIP ...................................................... 6

Going for the Long Haul .......................................................................................6

Staying Solvent ..........................................................................................................7

Together for the Common Good .......................................................................7

We “Make” the News ..............................................................................................7

Our Goal ......................................................................................................................7

IN RETROSPECT .................................................................................... 7

Our Advice ...................................................................................................................8

Contact Information ................................................................................................8

INDEX

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Field Report: Northern Virginia Dental ClinicDENTAL

The Northern Virginia Dental Clinic, Inc.,located in Falls Church, VA, has been caringfor patients since 1994. Inspired by privatepracticing dentists, it is the result of aharmonious partnership of dentists and localgovernments. The clinic has four operatoriesand a small paid staff generously supple-mented by volunteer dentists, hygienists andassistants. This report was written byThomas Wilson, Executive Director and BruceWyman, DMD, Chairman of the Board ofTrustees.

Field ReportPROJECT DESCRIPTIONThe Northern Virginia Dental Clinic (NVDC) is located in Falls Church,

VA, in the heart of five government jurisdictions which make up the

Northern Virginia region, part of the Metropolitan Washington, DC, area.

It primarily serves residents of Arlington and Fairfax Counties, and the

Cities of Alexandria, Fairfax, and Falls Church. The Clinic also serves

residents from Loudoun and Prince William Counties on a limited,

space-available basis.

Its mission is the establishment of a health care dental facility in which

volunteer dentists, dental assistants, dental hygienists, and receptionists

can provide health care services for the indigent population of Northern

Virginia. The clinic allows and encourages dental professionals to

donate their services through a collaborative, charitable effort. The

establishment of the NVDC began in 1993. The clinic opened its doors

to the public in February 1994.

Services Rendered:

Services offered by the NVDC include:

Examinations Periodontal Exams & Surgery

Intraoral & Extraoral X-rays Endodontics (root canal therapy)

Oral Cancer Screenings Prosthetics (full & partial dentures only)

Detailed Treatment Plans Hard & Soft Tissue Biopsies

Restorative (filings) Emergency Intervention

Prophylaxis (cleanings) Patient Education

Oral Surgery (simple & surgical extractions, oral tori removal, alveoplasty, etc.)

Current # of Professional Volunteers:

60-70 Dentists contribute more than 1600 hours annually

15-20 Dental Hygienists contribute more than 200 hours annually

20-30 Dental Assistants contribute more than 1800 hours annually

Current # of Other Volunteers:

5-10 Receptionist/Admin. contribute more than 100 hours annually



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Current # of Paid Staff:

5 – full time staff member, including: Executive Director

Dental Assistants (2)

Administrative Assistant

Receptionist

3 – part time staff members include: Dentist(s)

Patient Profile & Eligibility Criteria:

The average patient seen at the NVDC has not seen a dentist or received any form of dental treatment in the past 6-8

years. The clinic also serves a large number of immigrants who have never received dental health care. The average

patient needs a minimal of 6 appointments to complete all recommended treatment.

Patient eligibility includes:

• Resident of one of the Northern Virginia jurisdiction listed in the designated service area.

• Age 18 or older.

• Annual income within 200% of the Federal Poverty Guidelines (FPG). Note: 98% of NVDC patients are

within 125% of the FPG.

Hours & Days Of Operation:

8:30 am to 5:30 pm, Monday – Friday

Funding Sources:

Funding Sources include:

Program Fees - Fees paid by patients. ($30 per visit, a visit is 45- minutes, and as much work as possible is

completed during each visit.)

Grants - Funding is received through the United Way, local government jurisdictions, and private founda-

tions.

Contributions - Contribution made by individuals, businesses, organizations, civic groups, churches, etc.

In-Kind - Space is leased by local government jurisdictions.

VALUE OF A PUBLIC-PRIVATE PARTNERSHIPThe value of our public - private partnership is multifaceted.

• Local governments have clearly demonstrated their commitment in regards to the concerns and needs of their

residents. In return, residents have expressed their gratitude and described a heightened confidence in their

respective local government and elected officials for supporting a much needed program such as the NVDC.

• The Northern Virginia Dental Society, its Executive Committee, and its membership have demonstrated their

commitment to their chosen profession and to the community in which they live and work. In return, profes-

sional camaraderie has built alliances, which have strengthened the dental healthcare network throughout

Northern Virginia.

• Area social service agencies, both governmental and private, have come together to achieve a common goal.

This goal is to obtain critically needed dental health care to those individuals throughout their respective

communities, who would otherwise forego dental care due to cost and other barriers, if it were not for the

NVDC program.

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• The greatest value resulting from the NVDC program is the improved oral health condition of the individuals

served. Individuals have reported that due to their improved oral health; that their general health has improved,

they have been offered and secured better employment opportunities, and their personal relationships have

been positively affected. These changes have resulted in these individuals becoming more productive members

of their communities.

FIRST STEPS

Inspiration:

In the late 80’s and early 90’s, area dentists were being inundated with requests for pro bono services. In 1993, Dr.

Bruce Wyman and Dr. Peter Passero, periodontal partners in private practice in Fairfax County, Virginia, were approached

by a patient, who suggested that the Northern Virginia community of approximately two million people needed a facility

for treating adult indigent dental patients. He offered to introduce them to the deputy county executive of Fairfax County

in charge of human services.

Initial plans:

During the initial meeting with the deputy county executive, an obvious mutual understanding and need was arrived at.

All parties agreed that this would be a full-treatment facility, de-emphasizing emergency care. Patients would need to

pay part of their treatment and would be subsidized by outside funding. (All patients pay $30 of their own money for

each visit. This is a small fraction of the total cost of their treatment, but the government, community service and dental

communities wanted the patients to have a significant amount of self-esteem, as well as responsibility towards their

dental health. In some cases where the patients are below two times the federal property level, the Social Service

Agencies, [i.e. the governments] subsidize this patient cost.)

Volunteers would staff the clinic with full-time, professional, administrative help. Patients would be treated with dignity;

all treatment modalities would be utilized, except fixed crowns and bridges, as well as full dentures. The priorities were

to get the patients out of infection and pain, stabilize their mouths, and allow them to look more presentable to enter

the work force.

The partnership takes shape:

A community volunteer leader was also at the meeting, and over the several following months, helped to place the

dentist leadership in contact with various county agencies. It was also formulated that this would be a partnership of five

local governments: Fairfax County, Fairfax City, City of Alexandria, County of Arlington, and the City of Falls Church. The

Northern Virginia Dental Society would be the sponsoring agency for the indigent clinic. Social service agencies would

be employed by the various governments to financially screen the patients and set-up their first appointments.

Why was a public partnership preferable?

• Area dentists needed knowledge of the population they sought to treat through this project.

• Public social service agencies already had knowledge of the targeted population and the know-how to access

these individuals.

• A public partnership was desirable in regard to possible funding and stability of the project.

Drs. Wyman and Passer then teamed up with Dr. John Wilhide, the president-elect of the Northern Virginia Dental

Society, who had the same vision and was introduced by a mutual friend.

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CONVENING THE PARTNERSHIP

The public and private sectors come together:

The three dentists mapped out a strategy to get the dental society’s endorsement without asking the Dental Society for

any funding. The clinic was to be a stand-alone entity and produce its own source of revenue. They also worked with

the human services directors and county personnel to provide funding and logistical support. Fairfax County Depart-

ment of Human Services representatives invited other counties in the western part of the general area to participate, but

some of the outer-lying counties declined to participate due to the logistical difficulties that existed for their residents to

get to the clinic. Social Service agencies were each selected by the individual counties and funded accordingly by the

counties on a separate funding basis under ongoing contracts that were previously in place. Fairfax County DHS took the

lead in the County endeavors, as their population represents approximately 54% of the total area population, and they

are the most organized and well-capitalized government in the area.

Documenting the need:

Although studies and reports such as community needs assessments were available, both the private and public parties

knew of the need and the gravity of that need. So, no specific documentation was needed to get the important players

together. During the course of formulation, the local United Way also came out with a community needs assessment,

which indicated that adult indigent dental treatment was the second highest human service priority need in the metro-

politan area.

Harmonious discussions:

Facilitation of discussions amongst the three parties (dentists, governments, and social service agencies) was extremely

harmonious. The dentists usually organized the meetings and there was active participation by all factions. No agendas

were outlined as discussions simply flowed toward a mutual agreement for the good of all parties. We did not use a

neutral facilitator. Minutes of each meeting were recorded and disseminated to the parties involved.

It took eight months from the initial meeting between the dentists and the Fairfax County Deputy Executive of Human

Service to accomplish the opening of the clinic. It is incorporated as a private, non-profit organization.

Bricks and mortar:

After negotiating lease space for the clinic, Fairfax County signed a lease for the proposed space and negotiated a

separate agreement with the other four participating governments. They each took a share of the fixed overhead for a

minimum five year commitment; the share percentage was determined by their relative populations. The governments

also contributed $15,000 toward the initial purchase of capital equipment needed in the delivery of dental health care.

An agreement amongst the president of the Northern Virginia Dental Clinic, president of the Northern Virginia Dental

Society, and each of the county commissioners of the five jurisdictions, was signed and then construction was begun.

The construction was supervised by a committee appointed by the Board of Directors of the dental clinic, which was

composed of volunteer dentists, dental hygienists, and dental assistants as well as a representative from the govern-

ments and another representative from the Social Service agencies. The clinic reached out to various vendors and got

many concessions for supplies, equipment, and designing as well. The Board also hired an executive director and, soon

after that, hired two full-time dental assistants.

SUSTAINING THE PARTNERSHIP

Going for the long haul:

The momentum of the partnership has been maintained by constant communication. The Executive Director meets

regularly with the members of the Northern Virginia Dental Society’s Executive Committee. The clinic staff organizes all

of the monthly meetings with the Board, which include volunteer dentists, one representative from the social service

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agencies, and one representative from the local government. The government and social service representatives were

chosen by the government’s leaders.

Staying solvent:

Committees within the Board were set up to direct goals towards fundraising, volunteerism, government relations,

screening of patients by the social service agencies, dental society relations, and general public relations. The Dental

Clinic ultimately went to the State Legislature to procure funds ($25,000 each year), as well as from local charitable

foundations. The clinic found the foundations by way of other sources including local politicians, business leaders, dental

contacts, and government contacts. Five to twenty-five thousand dollar donations were made to the clinic by foundations

for the first year or two until, ultimately, a larger foundation (The Virginia Healthcare Foundation, which is 50% supported

by state funds and 50% by business) donated a three-year commitment to the clinic, which allowed the clinic to then

utilize this kudo as a means to procure additional funding and support.

Together for the common good:

Although all partners of the NVDC project are subject to the political process in one form or another (appointments,

elections, budgets), the agreement or partnership has never been jeopardized. This is most likely due to the fact that the

NVDC represents the sole source of comprehensive, yet affordable, dental health care for the low-income residents

throughout the entire Northern Virginia area.

For the past two years, the clinic has reached out to other government agencies for additional funding for paid dentists

who can treat larger numbers of patients. Because of this, the four dental operatory facility is now fully utilized and has

doubled its patient visits in approximately two years. The clinic has not been able to get enough volunteers (we have

had over 170 to date) to sustain full-time volunteerism.

No other jurisdiction has joined the partnership to date. However, there is currently a jurisdiction considering joining due

to the rapid growth of their community and the lack of affordable dental health care for its residents. If they join, they will

contribute to the leased space occupied by the NVDC based on a formula - the total population and low-income popula-

tion of each of the participating jurisdictions. The new partner would also designate social service agencies to serve as a

screening/referral source.

We “make” the news!

The clinic NVDC project has been featured in newspaper articles such as USA Today and the Washington Post, American

Dental Association and Virginia Dental Association Journals and other professional journals, local television, and local

United Way literature. The project is also a recipient of numerous national, regional, and local awards. It has been

declared a model clinic in almost all of its aspects given the nature of the three separate parties that help assure its well

being as well as the large number of volunteers and the professional staff.

Our goal:

To date, the NVDC has not entered into regional or state partnerships, although the goal is to expand to a second

(possibly more) site in order to serve a more regional population.

IN RETROSPECT:In retrospect, all selected parties need to have a “win” out of the situation in order for it to work. That is to say every-

body has a need.

• The governments had a need to serve, and the dental community had a need to give back to the population on

a selective basis.

• Social Service Agencies had a need to help their clients with utilizing government support.


• The NVDC clinic needed the Social Service Agencies to properly screen eligible patients.

• Government helped with its connections and seed money, although the government money at this point is a

relatively small percentage of the total input.

Looking back, the three most critical factors to keep in mind when forming a public-private partnership to increase dental

access are:

• the focus of the partnership and desired outcome(s)

• the contribution(s) that each partner can commit

• most importantly, ongoing communication between all participants in the partnership.

Our advice:

At one point, approximately three years after establishment of the clinic, financing became a desperate problem. The

leadership of the clinic went to the original Assistant County Executive of Fairfax County for Human Services and pleaded

their case. They knew that this individual had the power and the will and means to help the clinic. With further connec-

tions and support, the clinic was sustained through a trying time and now is flourishing once again, by way of productiv-

ity, as well as financially and esteem.

Perseverance! Don't Listen to the Nay-Sayers!

For more information contact:Thomas Wilson, Executive Director


5827 Columbia Pike, Suite 405

Falls Church, VA 22041

Phone: 703-820-7170

Fax: 703-820-7229

Email: [email protected]

Volunteers in Health CareA program of the Robert Wood Johnson Foundation


McHenry County Cooperative Dental Clinic




Field Report

PROJECT DESCRIPTION ...................................................................... 3

Available Services .....................................................................................................3

Paid Staff ......................................................................................................................3

Volunteers (to date) ................................................................................................3

Eligibility Criteria ........................................................................................................4

Hours & Days of Operation ..................................................................................4

Funding Sources .......................................................................................................4

FIRST STEPS .......................................................................................... 4

Recognizing the Need ............................................................................................4

The Partnership Takes Shape ..............................................................................4

The Hunt for Funding .............................................................................................4

Not-For-Profit Status ................................................................................................5

Getting “Buy-In” from the Dental Community ..............................................5

Finding the Right Space .........................................................................................5

SUSTAINING THE PARTNERSHIP...................................................... 5

A “Win-Win” Situation .............................................................................................6

Volunteer and Donor Recognition .....................................................................6

The Rewards of Working Together ....................................................................6

IN RETROSPECT .................................................................................... 6

A Final Word of Advice ...........................................................................................7

Contact Information ................................................................................................7

INDEX

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Field Report: McHenry Dental Clinic

“Using a Public-Private Partnership toCreate/Expand a Volunteer Dental Project”McHenry County Cooperative Dental Clinic

The McHenry County Cooperative DentalClinic, Woodstock, IL, began offeringdental services to low income, needypatients in 1997. A paid dentist/directorand receptionist/assistant, in addition to88 volunteer dental professionals,provide care in a three operatory clinic.The clinic is a joint effort between theMcHenry County Department of Healthand the McHenry County Dental Society.A large segment of its funding comesfrom a Community Development BlockGrant. This report was prepared byJoseph Hagenbruch, DMD, President ofthe Board of the McHenry CountyCooperative Dental Clinic.

Field ReportPROJECT DESCRIPTIONThe McHenry County Cooperative Dental Clinic, Woodstock, IL, has three

fully equipped operatories. It opened in August 1997 and since that time

has helped more than 3,000 low-income residents obtain treatment for

acute dental needs. In addition, 1,200 have received preventive services,

275 have been referred for specialty care, and 750 children have received

sealants.

The mission/goal of the clinic is to improve the oral health of McHenry

County residents through assessment, treatment, instruction, counseling,

referral, and provision of disease prevention services. The Cooperative

Dental Clinic provides services at low cost or no cost, depending on the

individual’s ability to pay. Currently, 25,000 persons are eligible for

services.

Ninety-seven percent of all adults screened by the dental clinic are in

need of dental treatment. Each possessed an average of 3.5 areas of

decay, of which forty-five percent were severe tooth destruction. In

screening children of all socioeconomic backgrounds, forty-six percent

were in need of dental treatment and fourteen percent had urgent needs with advanced dental disease/infection.

Available services:

Clinic: Oral diagnosis, operative restorations, extractions, periodontal, and preventive services.

Referral Services for special needs patients: Pediatric, sedation, surgery, endodontic, orthodontic, and prosthodontic.

Educational programs: For teachers, health professionals, and other community groups.

Public health experience: For student dental hygienists.

Arranged care: For dentally indigent children referred from HeadStart and Migrant Programs.

Paid staff: The clinic has 2 paid employees, a dentist-director, and a receptionist/assistant.

• The director supervises the dental clinic, coordinates and participates in the State Dental Sealant program, solicits

donations and supplies for the clinic and sealant program, and coordinates and seeks liaisons with dental schools

and hygiene schools to allow student supervised experiences with live patients at the clinic.

• The director also continually creates and updates policy, coordinates and supervises occupational safety and

health administration compliance for the clinic, secures dentists, dental specialists, dental hygienists and dental

assistants to provide volunteer care at the clinic. She also provides dental care at the clinic.

Volunteers (to date): Volunteers average 100 treatment days per year.

• 46 dentists and dental specialists have taken at least one turn providing service at the clinic. Several dentists have

come on numerous occasions.

• 14 dental hygienists have participated.

• 28 dental assistants have participated.

DENTAL

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• 14 dentist specialists accept clinic clients with special needs into their private offices.

• School nurses provide valuable hours to the sealant program.

Eligibility criteria: Income eligibility is based on annual household income, which must be at, or below, 185% of

the federal poverty level.

Days & hours of operation: Normally, there is a support person at the clinic Monday through Friday 8:00 am -

4:30 pm, to schedule appointments and arrange for emergency care. Our director dentist is there at least 3 days per

week, during which appointments are scheduled. Every week, three to four volunteer dentists supplement the paid

staff and are scheduled based upon their availability.

Funding sources: Community development block grants, donations, patient fees, and public aid.

FIRST STEPSThe project began as a joint effort between:

• the McHenry, IL, County Department of Health.

• the McHenry County Dental Society (a component of the Illinois State Dental Society and affiliated with the

American Dental Association).

Recognizing the need:

Early in 1993, it became evident that high numbers of low income residents were finding it increasingly difficult to

secure needed dental care:

• Private practicing dentists conducting screenings at child health clinics held at the health department, Head

Start health fairs, and health department health fairs, noticed many children had advanced disease. There

was no mechanism for follow-up care.

• The health department was receiving numerous calls from frustrated individuals asking for help in accessing

dental care. Low income was preventing them from securing dental care from the private sector. Medicaid

patients also had trouble finding a dentist willing to take them, because Medicaid fee disbursement to

dentists in Illinois ranked very near the bottom of the list among all states.

The partnership takes shape:

A dentist who was particularly concerned about improving access to dental care asked to serve on the health

department’s advisory board, in order to draw attention to the problems of access. In addition, he was an officer of

the local dental society, as well as a member of the county department of health’s professional advisory board.

Sharing his concern was the director of the health department. Together they set out to study and design a plan of

action. Other dentists in the county were asked for their opinions on developing and implementing a dental clinic.

The project evolved without formal work groups or committees. All in all, it took more than 2 1/2 years of meeting

two to three times per month, to create the clinic.

Members of the dental community were enthused about the idea of creating a dental clinic; however, there was

skepticism about how an effort of such scope could be managed and funded. The county health department was

also excited about the idea but needed time to appreciate the complexity of making the dental clinic a reality. Once

a budget was developed – with the help of the health department, the county dental society, a general contractor,

and a dental supply company – the search for funding began.

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The hunt for funding:

Initially, several foundations were asked for start-up funds. All of these requests were denied. Undeterred, the partnership

decided to request a portion of the community development block grant funding available to McHenry County. At first,

only a third of the request was granted. However, by the end of the first year, a surplus was identified and was subse-

quently given to the clinic. This brought the total of CDBG funding to $170,000 for the year. Currently, the CDBG request

for the year 2000 is between $42,000-$43,000. It is our hope to eventually increase the base of financial supporters and

decrease dependence on the Block Grant.

Not-for-profit status:

The project applied for and received 501(C)3 status, as a not-for-profit corporation. This was accomplished with the help

of the dental society. The clinic, however, operates with considerable help from the county health department. For the

present, it is considered a distinct division of the county department of health.

Getting “buy-in” from the dental community:

Although the clinic had a paid dental director from the onset, we knew we needed to supplement the clinic with volun-

teers. Recruitment began by sending a treatment profile sheet to every dentist and dental specialist in the county. This

served to introduce all county dental professionals to the existence of the clinic, stimulate their volunteer spirit, and allow

them to submit preferences in the types of dental procedures they would like to perform while serving at the clinic

facility. Dentists could chose between volunteering at the clinic or accepting referrals into their offices. Dentists seeing

patients in their own offices agreed to return any compensation received from Medicaid patients to the clinic. In fact, all

patient revenues revert back to the clinic to help with operating expenses.

Finding the right space:

• Over 50 locations were visited before it was decided to choose the existing location. The city of Woodstock is

essentially in the center of McHenry County. It is one of the area’s larger cities, with a wide variety of transporta-

tion modalities and public services. The clinic is one block from the train station, which adds another positive

factor in the location choice.

• The “build-out” to modify the facility for dental use was also considered in the location choice. The project was

put out for bid per county policy, and a selection was made based on the lowest bid. Some problems were

encountered – delays, inaccuracies, cost overruns, etc. Nevertheless, we do have a nice facility.

• The equipment and supplies were acquired through different methods, including: donations from dentists,

purchase of used equipment, and purchase of new equipment (two original chairs and related accessories were

purchased new). Working with antiquated equipment inhibits volunteering, so we equipped the clinic with the

most technically advanced equipment our budget would allow.

SUSTAINING THE PARTNERSHIP

The partnership between the dental society and the health department remains strong, because both organizations

understand that the clinic provides the best dental care available to low income populations. This could also be the

reason why the political processes of appointments, turnover, budgets, etc., have not had an adverse effect on the

partnership. Communication between the partners is ongoing; the dental society consistently receives updates.

Both partners assist with ongoing funding. The health department helps with the community development block grant

process and recently granted a stipend to be used to hire a part-time dental assistant. The dental society makes up the

difference on major equipment/product purchases after the clinic has done its best to procure outside funding.

Volunteer dentists are critical to the continuation of the clinic. The health department strives to provide an environment

that reflects good administration. Patients are scheduled with every attempt to accommodate those with special needs.

6


Referrals are handled efficiently. There is a real effort to discourage “no shows” — a problem known to deter

volunteerism and prevent timely care for responsible patients. Patients who fail to cancel an appointment, or simply

don’t show up, are not allowed to return.

The partnership also endures because the clinic functions as a central referring agency and administers numerous

referral programs with first-hand information about other community resources. This role of client/patient advocate, a

liaison between resources, dramatically improves access to care.

A “win-win” situation:

Private dental facilities can easily encounter overhead expenses in the 65% to 75% range. As a result, when care is

delivered by private offices to Medicaid patients, it literally “costs” providers. In a public dental clinic environment,

volunteer efforts by dental professionals are capable of controlling the usual overhead provider’s experience. All of this

is nominalized at the clinic through labor, product, and support donations, which allows for a “win – win” situation.

Volunteers gain the satisfaction of donating their services, and the patients receive the necessary treatment in a safe,

professional environment.

Volunteer and donor recognition:

Three large plaques mounted on the clinic waiting room wall recognize our volunteers - dentists, dental hygienists, and

dental assistants. Each volunteer has their name engraved on a metal plate that mounts via small screws onto the

applicable large plaque. They also receive a 5x7 inch plaque to acknowledge their contribution of service.

Another plaque recognizes those who donate supplies, money, equipment, advertising, equipment installation and

repairs, signage construction, and other support tasks. It is made of oak and assorted woods for individualized recogni-

tion display, and serves as a unique vehicle to honor those who have contributed to the ongoing project in ways other

than providing dental care.

The rewards of working together:

The dental needs of the county far surpass the capacity of the clinic. It is for this reason that we continually work to

prioritize, use resources efficiently (human and material), seek additional partnerships, recruit volunteers, work with

community leadership, develop programs that maximize community resources, and attempt to educate residents in

disease prevention measures.

Newspaper coverage of the clinic’s activities has stimulated donations from the community. An article in the American

Dental Association News several months ago prompted other counties in Illinois to contact the health department for

information on replication.

We expect the McHenry County Cooperative Dental Clinic to help our community for years to come. It will continue to

serve as a place for individuals to obtain care until they are able to transition to the private sector for their dental

needs.

IN RETROSPECT

When forming a public-private partnership, it is important to keep three things in mind in order to be successful.

• Find at least one person who is willing to be/stay at the helm and speak up for the idea.

• Secure enough funding to pay a dental director. This assures that patients will be seen regardless of the

supply of volunteers, and offers volunteers a sense of security and continuity. A clinic should not depend

solely on volunteers.


• Recruit a reliable corps of volunteers. Know what will make them comfortable in a clinic setting. If re-

quested, allow volunteers to bring their own instruments, hygienists, and assistants.

A final word of advice:

Don’t take “no” for an answer. Be resilient and persevere!

For more information contact:

Joseph F. Hagenbruch, DMD

502 North Hart Blvd.

Harvard, IL 60033

Phone: 815-943-5420

Fax: 815-943-5429


Volunteers in Health Care

A program of the Robert Wood Johnson Foundation

1

Field Report: Share Our Selves Free Dental Clinic




Field Report

Share Our Selves Free Dental Clinic

“Using Public-Private Partnerships toCreate/Expand a Volunteer Dental Project”

2


DESCRIPTION OF PROJECT ................................................................ 3

Our Primary Goal ..................................................................................................... 3

Our Staff and Volunteers ....................................................................................... 3

Our Patients ................................................................................................................ 3

THE VALUE OF PUBLIC-PRIVATE PARTNERSHIPS ......................... 4

A NEW STEP .......................................................................................... 4

Motivation..................................................................................................................4

Making our Presence Known..............................................................................4

Governance and Operations...............................................................................4

Multiple Partners......................................................................................................4

Funding Partners ...................................................................................................... 5

Partners Providing Goods and Services...........................................................5

SUSTAINING THE PARTNERSHIPS ................................................... 6

The Importance of Active Staff Members......................................................6

The Role of Executive Director............................................................................6

The Importance of a Fundamental Development Specialist..................6

A Thirty Year Track Record...................................................................................6

IN RETROSPECT .................................................................................... 6

This We Know ........................................................................................................... 7

ADVICE ................................................................................................... 7

Contact Information ............................................................................................... 7

INDEX

3

Field Report: Share Our Selves Free Dental ClinicDENTAL

“Starting a Dental Project Using the Clinic Model”Share Our Selves Free Dental Clinic

Share Our Selves, located in Costa Mesa,CA, opened its Dental Clinic in 1987, aspart of the organization’s comprehensiveoffering of free services to the homeless,unemployed, and working poor ofOrange County. The Clinic has fouroperatories, a small paid staff, and adedicated core of dental professionalvolunteers, who provide care. It issustained by it’s many public-privatepartnerships. This report was written byKaren Harrington, Director of Develop-ment.

Field ReportDESCRIPTION OF PROJECTSOS was founded in May 1970, by a group of concerned people,

primarily members of St. John the Baptist Catholic Church. Initially, food

and financial aid were offered. Services expanded to include the SOS

Free Medical Clinic in 1985, in response to the tremendous unmet need

for health care among Orange County’s low-income population. SOS

again expanded in 1987, opening the Free Dental Clinic, the only

comprehensive free dental clinic for adults in Orange County. For the past

thirty years, SOS has remained a volunteer-based organization and now

provides food, clothing, financial assistance, resources and referrals,

medical services, and dental care to those families and individuals who

are most impoverished in Orange County. The staff and volunteers (a

ratio of 21:400) are predominately bilingual and multi-cultural, and are

able to provide services in a non-judgmental manner, recognizing the

inherent dignity of each client.

Our Primary Goal:

The primary goal of the Free Dental Clinic is to assist its patients to preserve and maintain their natural permanent

teeth whenever possible. To reach this goal:

• The Dental Clinic provides high-quality emergency and preventive dental services, Monday through Friday,

8:00 am to 5:00 pm.

• One Sunday a month dental care is provided to teenagers belonging to Save Our Youth, a gang prevention

program in Costa Mesa.

• In addition to providing routine care, hygiene, and radiographs, SOS is the only free clinic in Orange County

with the capability to provide dentures and the expertise to undertake root canal procedures.

• The clinic operates with four chairs in a small clinic setting that includes the patient treatment area, dental

director’s office, and instrument sterilization. Plans to remodel will alleviate severe overcrowding in the dental

clinic.

Our Staff & Volunteers:

The Free Dental Clinic operates with four employees, two contract dentists, and 30 volunteers. The paid staff members

include the full time Dental Director, two full time dental assistants, and one .4 FTE dental assistant. The volunteers

include professionals and students in the fields of dentistry and dental hygiene. Dental specialists include oral sur-

geons and endodontists. The Dental Clinic also uses the services of a volunteer translator as needed.

Our Patients:

In 1998, the dental clinic provided 6,693 dental visits for patients who would have gone untreated. Typically, these

individuals have not been to a dentist previously, and many arrive in severe pain from infections.

These patients include the homeless, unemployed, and the working poor. The working poor tend to have jobs that do

not provide health benefits, or provide minimum coverage with high deductibles. These individuals are restaurant

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workers, nannies, housekeepers, car wash attendants, day laborers, and gardeners. Their income must be used for the

most basic living essentials, leaving little or no income for health care. Residents of most cities in Orange County make

use of our dental services, with the majority of patients coming from Costa Mesa (27%) and Santa Ana (34%).

THE VALUE OF OUR PUBLIC-PRIVATE PARTNERSHIPSThe Share Our Selves Free Dental Clinic provides a valuable one-of-a kind service to the low-income residents of Orange

County. The County provides for extraction and charges for the service. Five other clinics provide dental treatment. Four

charge a fee based on a sliding scale, and one has limited capacity. The patients must first make an appointment for

financial screening. Without a county hospital or another community clinic in the area, SOS is the “provider of last resort.”

As such, it is important that SOS consider the issue of sustainability of the dental operation. Successful, long running

dental clinics, such as SOS, have made an effort to develop and utilize multiple partnerships in the community, both in

terms of service and funding. It is vital that the operation not depend on one funding source to remain in business.

A NEW STEP

Motivation:

Share Our Selves was an operating, non-profit organization seventeen years prior to opening a dental clinic. This experi-

ence demonstrated to SOS’s Board of Trustees, staff, and volunteers the importance of developing partnerships in the

community. The partnerships are the result of outreach into the community by the board, staff, and volunteers.

Making Our Presence Known:

The Share Our Selves Board of Trustees, administrative staff, and volunteers all make a priority of being involved with

various public and private health care agencies.

• Health Care Council of Orange County Two board members, including our founder, are members of the Council,

increasing our access to county health care officials. Sustained advocacy by these board members on behalf of dental

services to the needy, resulted in a new county grant program – Augmented Access to Health Care. Presently, the

Health Care Council is very involved in advocating for the use of tobacco settlement money for health care. The Board

of Supervisors of Orange County has allocated the majority of the tobacco money for priorities other than health care,

resulting in a ballot initiative (aiming for November 2000), sponsored by the Orange County Medical Association, and

supported by a multitude of health care organizations, including the Health Care Council. If passed, this initiative will

allocate 80% of the tobacco settlement fund for health care.

• Coalition of Orange County Community Clinics The SOS clinic nurse manager is a board member of the Coalition.

He/She provides a forum for the fifteen member clinics to address county-wide problems, including continuum of

care, duplication of services, and advocacy for the poor, with county and state health care agencies.

• California Wellness Foundation The SOS Dental Clinic receives funding from this coalition.

Governance & Operations:

The governance of the clinics is the responsibility of the SOS Board of Trustees. The day-to-day operations of the clinics

are the responsibility of the medical and dental directors, the clinic nurse manager, and the medical/dental clinic

operating board. The operating board is comprised of medical and dental volunteers who actively encourage and recruit

volunteer health professionals to staff the clinics.

Multiple Partnerships:

The SOS Dental Clinic has formed multiple public-private partnerships in terms of who provides services, who receives

services, and who funds the operation. Service providers are 89% volunteers. Local dentists and endodontists donate

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their professional services both on site and in their private offices. SOS’s comprehensive dental services are provided to

adult, low-income residents of Orange County. The schedule allows time to see emergency appointments, and once per

month, accepts applications for new patients. Funding the dental clinic is a combination of private and public donations

of cash and in-kind equipment and supplies. As a free clinic, no fee is charged for services.

Funding Partners:

• Hoag Memorial Hospital Presbyterian. Share Our Selves is an integral part of the health care system for those

with no other access to health care. Our clinic is an integral part of the Community Benefits Program of Hoag

Hospital. The hospital provides funding, in-kind donations of pharmaceuticals, and the salary of two clinic

employees. Several top administrators of Hoag Memorial sit on our Board of Trustees. Most of our volunteer

physicians are on staff at the hospital. Hoag Hospital supports SOS because of the valuable, efficient service we

provide, and because we divert patients from their Emergency Room.

• Augmented Access to Health Care. A county program providing funding for contract dentists, computers, and

equipment. Members of the SOS Board of Trustees were integrally involved in development of this program.

• California Wellness Foundation. A private foundation funding contract dentists. This grant was written in collabo-

ration with the Coalition of Orange County Community Clinics.

• Community Development Block Grants, Santa Ana. Federal pass-through funds awarded to local social service

agencies at the discretion of the city. Santa Ana provides funding for dentist salaries through this program. To

access funding, it is necessary to write a grant and attend several city committee and council meetings.

• Community Development Block Grants, Costa Mesa. Costa Mesa provides funding for dentist salaries.

• Kaiser Permanente Community Service Fund. A private foundation funding dental equipment. The SOS director

of development submitted this grant.

• Microsoft. Software was donated to upgrade computer programs clinic-wide. A local company affiliated with

Microsoft was aware of our service to the community and called to suggest we submit a grant to Microsoft.

• Henry Schein. A vendor who regularly donates equipment and supplies to the dental clinic.

• DCI International. A vendor donating a dental chair to our clinic June, 2000. The connection was made by our

clinic nurse manager at a dental convention.

Partners Providing Goods & Services:

• Loma Linda University Dental School. A former volunteer from the initial years of the dental clinic went on to

receive his dental degree from Loma Linda, and returned to SOS as a volunteer dentist to institute a Sunday

outreach to Save Our Youth. This Costa Mesa gang prevention program is a private, nonprofit organization

providing academic, counseling, and recreational programs for at-risk teenagers. This group has typically not

experienced routine dental care. Save Our Youth was chosen because of the need, and because Share Our

Selves belongs to a local collaborative, Families Costa Mesa, with Save Our Youth. One Sunday each month,

dental services are provided to members of Save Our Youth by dental students from Loma Linda University. This

program is presently being considered for two Sundays per month.

• Cypress Community College. One day a week, dental hygiene students from Cypress are on site, providing

dental hygiene for our patients, and, in return, receiving valuable hands-on training.

• Coastline Community College. Students from Coastline’s Dental Hygiene Program also receive training at SOS.

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SUSTAINING THE PARTNERSHIPS

The Importance of Active Staff Members:

• The dental director networks with dentists and vendors, requesting volunteer and in-kind support for the clinic.

• Share Our Selves has a volunteer coordinator in place whose job is to recruit and train volunteers agency wide.

Ads requesting volunteers are run on a regular basis as a community service of the local newspaper.

• The executive director, the development director, and the medical and dental directors of SOS all speak to local

service clubs, schools, and other professional and business groups on a regular basis, making a case for finan-

cial, volunteer, and in-kind donations.

Role of the Executive Director:

Our Executive Director, Karen McGlinn, is a recognized leader in the community in advocacy for the poor.

• She chairs the Partnership for Responsible Public Policy, a broad consortium of 60 agencies who advocate for

good public policy.

• She serves on the Orange County Interagency Task Force, a task force set up by the Orange County Department

of Social Services. Every department in the county has a representative on this task force.

• She also serves on the executive committee of the Orange County Health Needs Assessment, is a member of

the Orange County Child Care Planning Council, sits on the advisory council of Leadership Tomorrow, and the

Daily Pilot editorial advisory board.

• She chairs Families Costa Mesa, a consortium that includes the Newport-Mesa Unified School District, Human

Options, the Assistance League, the YMCA, Orange Coast Interfaith Shelter, Save Our Youth (a gang prevention

program), Hoag Memorial Hospital Presbyterian, and St. Joachim’s Church.

• She is a leader and member of countless other public service agencies, giving her a unique global insight into

the priority issues facing Orange County.

The Importance of A Fund Development Specialist:

SOS has found it important to have a Fund Development Specialist on staff who has the knowledge and time to pursue

funding opportunities. The competitive nature of most funding opportunities requires a staff position dedicated to the

process of sustaining funding of important, free dental services.

A Thirty Year Track Record:

The partnerships SOS has developed, and continues to develop, are the result of thirty years of involvement as an

integral part of the county health care delivery system. SOS has met with success in developing these partnerships

because of our high quality of care, our efficient use of resources, and our outreach to other agencies.

IN RETROSPECTShare Our Selves has provided for the basic emergency needs of the poorest residents of Orange County for the past

thirty years. SOS has provided for these needs while collecting no fees for service. The two most important factors in

keeping our programs running are:

• the use of volunteers - Agency-wide, SOS is 95% volunteer staffed. These volunteers are professionals, both

retired and still practicing, local retired individuals (church members provide many of our volunteers), and

students. The large number of clients and patients we are able to serve is the direct result of this committed

volunteer force.


• the ability to attract a multitude of funding sources - An important factor in attracting funders is the establish-

ment of trust in the community. Particularly, local individuals, businesses, and foundations respect the work SOS

accomplishes, and trust that donations are used for direct service to the needy. Administrative costs, including

fundraising, are 9%; less, if a dollar figure is given to volunteer labor.

This We Know:

The specific organizations involved with SOS’s Free Dental Clinic will change over time. This change will be partly the

result of the competitive process of funding from private and public funding organizations. In addition, the needs of non-

profits and those they serve may change over time as other programs and opportunities present themselves. SOS will

continue to search out new funders and additional volunteers. SOS will continue to belong to Families Costa Mesa, the

Coalition of Orange County Community Clinics, and a multitude of County agencies to keep abreast of dental services,

and stay current with funding opportunities.

ADVICEIt is important that any nonprofit become involved in their local community, collaborating with others to access funding

and increase the scope of services.

For Further Information contact:Karen Harrington, Director of Development

Share Our Selves Free Dental Clinic

1550 Superior Avenue

Costa Mesa, CA 92627

Phone: 949-642-3451

Fax: 949-642-7885


Volunteers in Health CareA program of the Robert Wood Johnson Foundation

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