MODELS FOR PRACTICE
FOCUS
AREA: ORAL HEALTH
Program Name: FirstHealth of the
Location:
Healthy People 2010 Objective: 21-1; 21-2a, b, c; 21-8;
21-10; 21-12; 21-14
Web Address: http://www.firsthealth.org
The
FirstHealth of the Carolinas Dental Health Program serves five counties in
central
Blueprint:
The FirstHealth of the Carolinas Dental Health Program delivers dental health
services through three established clinics to five nonmetropolitan counties in
central
Making
a Difference: FirstHealth Dental Program
opened the first of three clinics in 1998. To keep the doors open, it embarked
on a diligent mission of seeking financial sustainability. In addition to
maintaining strong relationships with charitable foundations, FirstHealth also
seeks funding through national, state, and local resources. A significant
portion of FirstHealth’s funding was obtained through the Community Voices
Initiative of the W.K. Kellogg Foundation.
FirstHealth utilizes a variety of performance measurements including
process, outcome, and perception indicators. By tracking the number of patient
encounters, health care coverage status, and demographics, the data revealed
that as of April 2002, the three centers had treated almost 65 percent of the
approximately 12,000 underserved and uninsured children in the service area.
This is in stark contrast to the state average of 22 percent. Outcome
indicators reveal that the centers increased by 600 percent the number of
children receiving sealants, transitioned more than 30 percent of children into
preventive maintenance status, and achieved a no-show rate of 16 percent.
Comparatively, the national no-show rate is 30 percent. The program also
monitors financial indicators. As anticipated, FirstHealth’s expenses exceed
revenues by 9 percent; however, the difference is supplemented by grants and
the FirstHealth Community Benefit Program.
Finally, FirstHealth is a pioneer in the use of nontraditional
providers as a mechanism to address the shortage of dental providers.
FirstHealth offers training sessions to pediatricians and family practitioners,
which are designed to instruct these providers on applying fluoride varnishes
to small children’s teeth. To date, 140 physicians, nurses, and clinical staff
have been trained to deliver this service.
Beginnings: FirstHealth Dental Health
Program began with a public outcry from public health hygienists and school
nurses to FirstHealth of the
Three clinics (one full time and two part-time) were
opened in the nonmetropolitan counties of
Challenges and Solutions: FirstHealth of the
FirstHealth also realized that since the patients
were not privately insured, a deficit was inevitable. Therefore, FirstHealth
subsidizes the program through the FirstHealth Community Benefit Program.
FirstHealth has also pursued a variety of other funding sources including the
American Dental Association,
Another challenge encountered by the program was uncertainty by local dentists as to the need for FirstHealth to provide dental services. However, the task force (which included local dentists) reviewed data on the dental crisis and determined the need for FirstHealth’s Dental Program.
FirstHealth Dental Program utilizes a variety of
channels to publicize its program to clients at the community and state level.
The program also pursues policy changes in order to have the greatest impact on
improving access. Locally, FirstHealth works closely with local schools and
provides informational materials to every elementary school child. The program
has also implemented a variety of other creative publicity measures targeting
local, state, and charitable sponsors.
Sharon
Nicholson Harrell, DDS, MPH, FAGD
FirstHealth
of the
Phone:
(910) 692-5111