“Federal Funding for Oral Health: The Financial Model for Federally Qualified Health Centers (FQHCs).”

Successful Models of Partnership Between Schools and Health Centers

54th Annual ADEA Dean’s ConferenceNovember 12, 2012

Rick Mumford, DMD, MPH

Clinical Associate Professor

Director of DISC Program

UNC-School of Dentistry

Department of Dental Ecology

Extramural Clinical Rotation’s Role in

Community – Based Clinical Dental Education UNC - SOD and Community Health Centers

Our primary partners – NC AHECs & NCCHCA

Dentistry In Service to Community – (DISC) Program

Extramural Clinical Rotation’s Role in

Community – Based Clinical Dental Education UNC - SOD and Community Health Centers

How we make the program work - How the parts How the parts work together to achieve our respective missionswork together to achieve our respective missions

UNC – SOD DISC – Community-based

Extramural Clinical Programs:

An Educational Mission

       

Dentistry In Service To Communities

•DDS Students Summer 3rd Year clinical rotations – required (8 weeks)

•DDS Students All other clinical additional rotations•Student Health Action Coalition (SHAC) - Volunteer student clinic

entering its fourth decade.•DH Student practicums – required (3 weeks) many NC communities•International Projects – Students learn a global perspective of service•ENNEAD Student Volunteers – NC Public Schools, NCDS-MOM

clinics and community health fairs•Student Organizations – such as “Sealant Saturdays” Greene County

Notes: A full-time faculty or adjunct is required onsite as attending and preceptor for clinical activities. These are volunteer, non-paid adjuncts.UNC-CH partners with NC AHEC to provide AHEC housing during required clinical rotations

UNC - SOD Extramural rotations - 4th Year Students

Dentistry in Service to Communities – DISC Program

DISC PROGRAM GOALS The DISC IV extramural program has two primary goals:

•To give students an opportunity to observe and participate in a variety of oral health care delivery systems – public dental practices while providing clinical care

•To expose students to a diverse patient population, including those with special needs – which students would be unlikely to encounter in the dental school clinic - but which are represented in communities where dentistry is practiced (two 4-week rotations required; one - a public dental practice and one – a hospital rotation)Note: With course director permission, two general practice rotations are permitted

UNC-SOD DISC Students – Clinical Credit Received

Currently four departments allow clinical credit for some procedures completed on extramural rotations:

• OMFS allows up to 20 extractions

• Prosthodontics allows 2 full sets of dentures

• Pediatric Dentistry allows credit for child patients seen in pre-approved sites with boarded pedodontists

• Diagnostic Sciences & General Dentistry

Allows credit for biopsy submission

Extramural Clinical Rotation’s Role in:

Community – Based Clinical Dental Education - UNC - SOD and NC AHEC: A training mission

Our primary partners – NC AHECs & NCCHCA

http://www.ncahec.net/

8

NC AHEC Regions

DISC Sites by

AHEC Region

       

Extramural Clinical Rotation’s Role in:

Community – Based Clinical Dental Education

UNC - SOD and NC CHC: A healthcare access mission

Our primary partners – NC AHECs & NCCHCA

http://www.ncchca.org/

12

Dentistry In Service to Community – (DISC) Program

NC Counties served Summer 2011 Total students

78

Alamance Chatham

Cumberland Durham

Forsyth Burke

Gaston Buncombe

Greene Catawba

Granville Robeson

Guilford Wayne

Orange Wilkes

New Hanover Jones

Mecklenburg Edgecombe

Orange Moore

Person Haywood

Pitt Lincoln

Sampson Stanley

Rowan Wake

Wayne (Represents 66 active sites)

DISC Rotations 2011 – Total (156)115 Student Rotations in NC - 74% 41 Student Rotations U.S. other or international – 26%

10/19/12

1

2

3

4

5

6

7

89

10

11

12

13

14

15

1617Cherokee

Graham

Swain

Clay

Macon

Jackson

Transylvania

Henderson

MadisonYancey

MitchellAvery

McDowell

Polk

Rutherford Cleveland

Caldwell

Watauga

AsheAlleghany

Wilkes

Alexander

Iredell

Davie

Yadkin

Surry Stokes

Davidson

Stanly

UnionAnson

Richmond

Montgomery

Randolph

Rockingham Caswell

Wayne

Scotland

Hoke

Robeson

Columbus

Brunswick

Pender

Bladen

Cumberland

Moore

Lee

Harnett

Chatham

Johnston

Nash

Person

Vance Warren

Halifax

Northampton

Duplin

Onslow

Jones

Craven

Carteret

Hertford

Gates

Pasquotank

CamdenCurrituck

Bertie

Martin Washington Tyrrell Dare

HydeBeaufort

Pamlico

Haywood

Buncombe

Burke Catawba

Lincoln

Gaston

Mecklenburg

Cabarrus

Rowan

Forsyth

Guilford Alamance

Orange

Granville

Durham

Franklin

Wake

Sampson

Lenoir

Greene

Pitt

Wilson

Edgecombe

NewHanover

DISC Rotation Sites in North Carolina by County

42 Blue Counties indicate presence of DISC Sites

66 Active NC DISC Sites

Dentistry In Service to Community – (DISC) Program

Community Health Centers - 2012Outside NC:

Colorado - Peak Vista CHCGeorgia - Good Samaritan - AtlantaMaine - Penobscot CHS (some others less often)

Key Program Costs $:

•Staffing – 2 FTEs (1-Faculty, 1- Staff)•Student Stipend (Inside NC ↑ 35 miles)•Housing (Inside NC ↑ 35 miles)•Preceptor Annual C.E. Event•Travel (New sites, Troubleshooting)•Misc.

Cost Estimates $:

•Staffing = ~ $250,000•Student Stipend = ~ $18,000•Housing = ~ $6,000 ($5.00/night)•Preceptor Annual C.E. Event = ~ $5,000•Travel = ~ $3,000•Misc. = ~ $5,000Approx. $287,000 to $290,000/yr

Funding Sources $:

•Staffing – 2 FTEs – AHEC (state funds)•Student Stipend - AHEC (state funds)•Housing - SoD (state funds/Dean’s Acct.)•Preceptor Annual C.E. Event – (Dean’s Acct.)•Travel - AHEC (state funds) or Dent Foundation•Misc. - Dent Foundation

+“In-Kind Cost of Preceptors & Clinics”

Find Partners with state funding and solid network of advocates & an inter-professional mission

Maximize use of “in-kind” resources (Existing clinics and dental staffs)

Incentives to partners:Community service reports to AHECWaive fee to post job openingsReduced rate or free C.E. to preceptorsAdjunct faculty appointments (CV help)Electronic use of health sciences librariesStudent stores discountGrant letters of supportReciprocate

Funding Sources $ Free Advice:

UNC – SOD DISC Program Highlight

       

AHEC Annual Report—School of Dentistry 2010-20111 October 2011

Using the UNC School of Dentistry's Dental Faculty Practice fee schedule, as it more closely reflects the cost assumed by patients at private practices, the students provided $1,302,938 in dental services to underserved populations in North Carolina.

UNC – SOD: Dentistry In Service to Communities Program

DISC + CHCs & AHECs = a successful partnership

Serving North Carolina “safety net” dental clinics and helping to

expand access to oral health care across the the state for over 20

years!

       

Rick Mumford, DMD, MPHDirector, DISC ProgramUNC at Chapel Hill - School of DentistryCampus Box # 7450 Chapel Hill, NC 27599-7450rick_mumford@dentistry.unc.eduT - 919.966.2787F - 919.843.1170

Thank you – Questions?

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