OUR CURRENT REALITY

Upper Peninsula Children’s Oral Health SummitNMU Conference Center

May 17, 2014--Kayla West, MBA

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500

1,000

1,500

2,000

2,500

3,000

Dental Visits in 2012--Medicaid Children Ages 0-4

Total Eligible1 or More Visits

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0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Dental Visits in 2012--Medicaid Children Ages 0-4

No Visits1 or More Visits

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500

1,000

1,500

2,000

2,500

3,000

Dental Visits in 2012--Medicaid Children Ages 5-14

Total Eligible1 or More Visits

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0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Dental Visits in 2012--Medicaid Children Ages 5-14

No Visits1 or More Visits

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500

1,000

1,500

2,000

2,500

3,000

Dental Visits in 2012--Medicaid Children Ages 15-20

Total Eligible1 or More Visits

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0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Dental Visits in 2012--Medicaid Children Ages 15-20

No Visits1 or More Visits

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500

1,000

1,500

2,000

2,500

3,000

Dental Visits in 2012—Medicaid Adults Age 21-60

Total Eligible1 or More Visits

Alger

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0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Dental Visits in 2012—Medicaid Adults Age 21-60

No Visits1 or More Visits

0%

10%

20%

30%

40%

50%

60%

70%

80%

Household Income Correlated With Health Status and Access To Care

(WUP CHNA)$0 - $24,999

$25,000 - $49,999

$50,000 or more

Western UP Overall

• Coverage & Financing

• Safety Net• Workforce• Prevention• Surveillance

5 Buckets

Focusing on “Systems”

Remember the 1980’s—Haven’t we been here before?

• 2000 US--Former Surgeon General David Satcher’s “Silent Epidemic”• 2000 SOM--Healthy Kids Dental for Medicaid Children (22 counties)• 2000 SOM—Community Dental Clinics North – 21 counties• 2000 SOM—4th Year Dental Student Externships• State Office of Oral Health

• Fluoride Equipment Grants• Varnish! Michigan, Varnish! Michigan – Babies Too!• SEAL! Michigan

• 2003 SOM—Michigan Oral Health Coalition• 2004 Michigan Community Dental Clinics, Inc.• 2012 US—Affordable Care Act• 2014 SOM—Medicaid Expansion With Adult Dental Benefits

Driving Distances – 30 Minute

Radius

Distribution of Safety Net Dental Clinics

Uninsured adults only

Which Safety Net Dental Clinics Will See Children in 2015?

Dr. Brian Anderson--Hospital Cases (10/12 – 4/14)

Number of Cases by Year Number of Cases by Age

1 2 3 4 5 6 7 8 9 10 11 120

2

4

6

8

10

12

14

16

18

10

5

10

15

20

25

30

35

40

45

2011 2012 2013 2014

Distribution of Hospital Cases for Children

Hospital Cases—Dr. Brian Anderson

$ Billed vs. $ Reimbursed Billed vs. % Reimbursed

1 6 11 16 21 26 31 36 41 46 51 56 61 66 71$0

$1,000

$2,000

$3,000

$4,000

$5,000

$6,000

$7,000

1 6 11 16 21 26 31 36 41 46 51 56 61 66 710.00%

10.00%

20.00%

30.00%

40.00%

50.00%

60.00%

70.00%

80.00%

90.00%

100.00%

% Reimbursed

Fluoridation of community water supplies is “One of the greatest public health advances of the last century.” (Centers for Disease Control and Prevention) 33% of the UP population

has access to fluoridated community water systems.

Sources: Kayla West (Oral Health for All Coalition). Map by Eric Anderson, PHD, Senior Planner, County of Marquette Data from John Clark, DEQ.

Do Health Departments Apply Fluoride Varnish in

MIHP and WIC Programs?

Yes

Yes

Yes

Marquette County, Pop. 67,906 (2012)

FRL = Free/Reduced Lunch• Community Water System With Fluoride• Community Water System No Fluoride

Marquette**Cherry Creek = 378,

27% FRLVandenboom = 20,

10% FRLSandy Knoll = 376,

38% FRLSuperior Hills = 294,

27% FRLGravereat = 122,

46% FRLMiddle = 860,

29% FRLHigh School = 1042,

38% FRLNorth Star = 271,

62% FRL RESA = 60 42% FR Total Students: 3,423

PowellK-8 = 46, 52% FRL

Ishpeming Birchview = 310, 55% FRLMiddle = 254, 48% FRLHigh School = 266, 36% FRL

Total Students: 830

Republic-MichigammeK-12 = 136,

63% FRL

WellsK-8 = 12, 75% FRL

Gwinn Sawyer

West Ishpeming, NICE

Aspin Ridge = 823, 32% FRLWestwood = 345, 19% FRLTotal Students: 1,168

Sawyer Elem = 285 , 87% FRLGwinn Elem = 263, 59% FRLMiddle = 262, 70% FRLHigh = 386, 51% FRLTotal Student Pop. = 1,196

Negaunee Lakeview = 738, 33% FRLMiddle = 326, 32% FRLHigh School = 421, 30% FRL Total Students: 1,485

I’m sure glad the hole isn’t in our end…..

Source: Russell Ackoff (http://www.youtube.com/watch?v=UdBiXbuD1h4)

END OF OVERVIEW

LUCE COUNTYCase Study of a “Positive Deviant”

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What Percentage of Healthy Kids Dental Children, Ages 0-4, In Each County, Had At Least One Dental Visit in 2012?

With 1+ Dental Visits in Past Year Without Dental Visit in Past Year