Oral Health InitiativeGrantee Launch Meeting

April 11, 2006

Welcome, Introductions and Meeting PurposeTangerine Brigham, Community Health Program Officer, welcomed grantees to the launch meeting of the Oral Health Initiative Advisory Committee. Grantees made introductions and reviewed the meeting’s purpose.

Overview of Oral Health Initiative Grantee received an overview of the OHI. Specifically, the grantees reviewed the Initiative’s planning process, objectives, components and implementation activities. Grantees received a PowerPoint presentation with detailed information on each of these aspects. Grantees also received summary information on the OHI Advisory Committee. The Committee serves three functions:

o Provide advice on Initiative implementation o Provide feedback and suggestions to ensure that Initiative meets its

objectives Service expansion Delivery system Advocacy and system reform Education and communication

o Provide guidance on Initiative’s priority funding areasGrantees were directed to Tab 4 that provides additional information on the Advisory Committee.

OHI ProjectsGrantees were directed to Tab 3 of the Orientation Binder which provides summary information on the OHI projects. In summary, eight projects have received funding to date totaling $680,000. Six grants are for implementation and two are for planning. A grant was awarded in each of the five counties within the Foundation’s service area. Five of the grants are collaborative efforts and three are single agencies (principally local health departments). The grants cover all of the OHI’s priority areas with the majority focusing on access to care, education/health promotion and

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provider training. A majority of the grantees either focus exclusively on children or have children within the targeted aged group.

Grantees stressed to need to ensure that funded projects did not work in isolation, but gained knowledge from other grantees. With respect to cross collaboration and sharing lessons learned, grantees made some of the following suggestions:

o provide regular opportunities for grantees to meet and share project experiences – both challenges and successes,

o provide a forum for grantees to share materials/data (e.g., benefits of care coordination and role in increasing reimbursement, avenues to reduce no-show rates, best practice models for medical/dental coordination, internal referral procedures used by grantees, mechanisms for recruiting volunteers, etc.) and for TSFF to share materials that can be readily accessed by all grantees via the Internet or another electronic medium,

o provide grantees with the contact information and summary projects of all OHI participants.

Grantees expressed interest in TSFF helping address long-term sustainability and in the OHI effort tracking the work of the Dental Pipeline.

Brainstroming: Public Policy/Advocacy and Public Education/Strategic CommunicationsPublic Policy and AdvocacyGrantees indicated that the current system for delivering and financing dental services is broken and is in need of repair. It was noted that a California Dental Association survey taken five years ago found that dental providers are less willing to accept patients with public dental insurance due to: (1) bureaucracy, (2) patient no-show rate and (3) low reimbursement rates. It was noted that the following are issues that needed policy and advocacy focus:

Policy Issue RecommendationDelivery System Develop and adopt, if appropriate, new models of care

coordination Develop system where dental hygienists can function

as oral health coordinators and emphasize prevention in oral health.

Document the case/care management component to assist in advocacy for reimbursement.

Fluoridation Increase access to fluoridated water in the five counties. This recommendation has both fiscal and policy implications.

Health Develop mechanisms to increase dental health literacy

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Promotion and Education

among parents/guardians and dental health consumers.

Public Program Simplification

Explore mechanisms to developed standardized reporting and reimbursement forms for Denti-Cal, Healthy Families, etc.

Reimbursement (State-funded Programs)

Obtain reimbursement for care management services Increase reimbursement rates from/to Delta Dental

(i.e., from the State to Delta Dental and from Delta Dental to providers)

Reduce bureaucracy surrounding reimbursement for services.

Obtain reimbursement for oral health education. Provide funding for the Head Start required dental

exam which is currently an unfunded mandate.

With respect to reimbursement, it was stated that effective July 2006, the application of fluoride varnish will be a reimbursable service under Medi-Cal/Denti-Cal.

Other issues raised during this discussion were the need to ensure that health promotion materials are translated into appropriate languages given the demographic make-up of the communities served by grantees. It was also mentioned that transportation is often times a critical factor for may potential dental patients and that the lack of accessible transportation negatively contributes to high no-show rates.

Public Education and Strategic CommunicationsGrantees noted the challenges inherent in developing a public education/communications strategy for oral health: oral health competes for “air time” with other health and social services issues that appear more urgent in nature, general public does not perceive of oral health disease as an infectious and communicable disease, or understand the ramifications of chronic diseases

Some of the ideas that grantees surfaced were: o developing a public education message that highlights the impact of

oral health on physical and mental health, o creating a volunteer base for public education and prevention using

the health worker/ promotora/lay person model, o working with California New Media to determine if they can be of

assistance in helping craft and/or placing oral health prevention messages for ethnic media,

o determining if a consortium of funders would be interested in the notion of social marketing,

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o using the media to make the direct link between nutrition and dental health,

o working with the Bay Area Dental Deputy Directors group to determine what common public education strategies have been employed across the nine counties.

The University of Pacific noted that it has received a grant to train social workers on how to conduct risk assessments and provide oral health education.

As grantees discussed the communications component, there was a realization the oral health was in need of the “tipping point” – that moment when an issue is placed on a larger stage and gains a larger following. For both the policy and communications activities, grantees suggested a convening of funders to discuss how to more effectively frame oral health issues for the public and for policy stakeholders.

Grant MonitoringGrantees will be required to report on their progress in achieving their goal(s) and outcomes. A standardized reporting template will be developed which will also support the overall OHI evaluation. In addition, grant monitoring will also include site visits for all grantees who received implementation funds. Site visits will be done on an annual basis. Finally, on an annual basis, grantees will provide a financial report on the use of grant funds.

OHI EvaluationTSFF staff provided an overview of the OHI evaluation. The evaluation is designed to determine the following:

o whether the Initiative's objectives were met in,o whether grantees achieved their outcomes,o whether funded projects can be replicated and under what

conditions,o what conditions are needed to sustain funded programs, ando ascertain the Foundation's ability in launching and managing the

Initiative.

The evaluation will be structured to include:o formative and summative components, o quantitative (i.e., outcome) and qualitative (i.e., process)

evaluation,o an evaluation instrument and methodology (i.e., data elements,

data collection and analysis),

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o mechanisms to assess grantee interventions, intermediate outcomes (during life of grant) and long range impact, and

o technical assistance to grantees.

Grantees reviewed the timeline for selecting an evaluator. TSFF staff indicated that grantees would be informed as soon as an evaluator had been approved by the Foundation’s Board of Trustee.

TSFF staff stated that the OHI evaluation had been discussed with the Advisory Committee and that the Committee strongly recommended that TSFF expand its role to include helping ensure sustainability of the projects (if appropriate) after funding ends and that TSFF be evaluated on its ability to assist in this area.

Grant Agreement Issues It was announced that the Foundation had mailed out all the grant agreements last week and that grantees should review the grant and sign if appropriate. Funds will be disbursed after the signed grant agreement is received by the Foundation. Any questions regarding the grant agreement should be directed to either Ms. Brigham (tmb@sff.org) or Catherine Mercado (ctm@sff.org).

Making Grantee Meetings UsefulGrantees felt that it was useful to meet on a regular basis and that it would be important to use grantee meetings to: share information, discuss best practices, discuss challenges

Next Meeting The next meeting of OHI Grantees will be August 22, 2006 from 11:00 am – 3:00 pm at The San Francisco Foundation. An agenda and meeting packet will be sent out prior to the meeting.

Materials Distributedo Oral Health Initiative Grantee Orientation Bindero OHI Powerpoint Presentation

Grantees in AttendanceContra Costa Oral Health Project

o Padmini Parthasarathy Geriatric Oral Health Access Program

o Rolande Telliero Jon Roth, CAE

Healthy Kids, Healthy Teeth Expansiono Sandi Goldstein

Marin County Oral Health Coordination Project

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o Sandra RosenblumOral Health Policy Development

o Dr. Paul GlassmanPractice Management System

o Patricia BarreraPre- and Post-Natal Oral Health Project

o Ann Marie Silvestri, DDSSan Francisco Kids and Infant Oral Care Program

o Dr. Carolyn Brown

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