Community Task Force on Oral Health Needs of People with Developmental Disabilities

KEY FINDINGS

Workgroup Leaders

Demographics: Who is Receiving What from Whom?– Ann Costello and Brian Klafehn

Consumer Perceptions and Satisfaction– Lenora Colaruotolo

Provider Experiences and Expectations– Lisa DeLucia

Current and Unfolding Policy– Rich Speisman

Model IDD Oral Health Care Programs– Maricelle Abayon.

Facilitator– Larry Belle

Demographics: Who is ReceivingWhat from Whom?

FLDDSO - 9,300 individuals in 2012 - Monroe, Wayne, Ontario, Livingston, Orleans.

12,000 in the 11 county Finger Lakes region.

Monroe County (55%); with 40% between the ages of 21-44 years; and 35% living in some type of certified residence.

EIOH, RGH, Anthony Jordon, CP Rochester and FLDDO Dental Clinic - 2,786 patients (2011)-Wait time -ambulatory <6 months, OR >12 months.

<17% private DDS see Medicaid.

Development of a standard patient classification system to be used by the community-based clinics as well as private practice dentists.

Clarify the actual number of individuals receiving dental services on an annual basis by using DOH Medicaid claims data.

Determine how many individuals are not receiving routine, preventive dental services and why?

Work collaboratively with local area hospitals to reduce wait-time for needed OR services and improve oral health to mitigate the need for OR services.

Demographics: Who is ReceivingWhat from Whom?

Consumer Perceptions and Satisfaction

Determine areas of oral health satisfaction, perception and need.

Survey of local agencies and Focus groups of constituents.

8% Individual

32% Parent

2% Guardian

29% Other

29% Care Provider

Type of Respondent

Type of Respondant

Regularity of Past Dental Attendancen=560

102,18.20%

48, 8.60%

410, 73.20%

Regular Dental VisitOccasional Dental VisitOnly if Trouble with Teeth

Consumer Perceptions and Satisfaction

Perceptions on Oral Health Care

Oral H

ealth

: Exc

ellen

t/Good

Oral H

ealth

: Fair

/Poor

Oral H

ealth

Importa

nt

Anxiety

about D

entis

try

Provid

er Optio

ns: Diss

atisfi

ed

Provid

er Optio

ns: Sati

sfied

Knowledge/F

riendly:

Hyg

ienist

Knowledge/F

riendly:

Den

tist

Satisfi

ed w

ith tre

atmen

t

Saw a

dentis

t in th

e pas

t yea

r

Visit D

entis

t eve

ry 6 m

onths0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

47%53%

70%74%

20%

60%

77% 77%72%

85%

73%

Suggestions for Improvement

80% of dental disease occurs in 20% of the population-the most underserved and least likely to access services and care. (NOT SAMPLED)

Patient-centered care.

Knowledgeable staff and practitioners.

Universal design.

The concerns and requests of the family members should be incorporated into any systemic design of oral health services for this population.

Provider Experiences and Expectations

Surveys and Focus Groups.

7th District Dental Society and Dental Hygiene Society, RGH and EIOH.

151 respondents – DDS 59% (high % specialists and institutional providers), OH 41%.

Close to 70% of respondents treated individuals with IDD and feel relatively comfortable and competent doing so.

Respondents felt more competent and prepared to treat patients with mobility issues than they did with patients who had communication and behavioral limitations.

High % wanted additional training.

Topics for Continuing Education

0%

10%

20%

30%

40%

50%

60%

70%

41%

59% 60%

25%21% 19%

38%42%

Current and Unfolding Policy

Managed Care.

Fragile and ever-changing dental reimbursement picture.

Reduction or elimination of services.

Dental Accreditation.

Role of Dental Hygienists.

Inefficient and limited use of OR care.

Dental Disco Advisory Group (DDSG).

Opportunity for demonstration projects.

Model IDD Oral Health Care Programs

Atlantic County Special Services School District by University of Medicine and Dentistry of New Jersey.

The Special Smiles Program – Philadelphia.

Tufts, Boston – closed.

Glassman, San Francisco.

Glassman Model California

Focuses on prevention of dental diseases.

Utilizes a case management approach.

Employs a tiered delivery system.

Provides care as close as possible to where individuals with IDD disabilities live, work and go to school.

Enables hygienists to play a major role in oral health maintenance, as well as in education of family and caregivers.

Use of Tele-health.

Uses existing community health professionals in new ways.

Rewards services that will improve oral health.

Website

Full report and executive summary can be found on the following website:

http://www.urmc.rochester.edu/dentistry/news-events.aspx