HomeMy WebLinkAboutAgenda - 03-21-1995 - VIII-A 1
Y
ORANGE COUNTY
BOARD OF COMMISSIONERS
Action Agenda
Item No. A
ACTION AGENDA ITEM ABSTRACT
Meeting Date: March 21, 1995
SUBJECT: Smart Start Award, Dental Project.
DEPARTMENT: HEALTH PUBLIC HEARING: Yes X No
ATTACHMENT(S) : INFORMATION CONTACT:
HEALTH DIRECTOR'S OFFICE X2411
1. A grant proposal.
2. Notice of Award.
TELEPHONE NUMBER:
Hillsborough - 732-8181
Chapel Hill - 968-4501
Mebane - 227-2031
Durham - 688-7331
PURPOSE:
To accept a $32,890 dollar grant award from the Orange County Partnership
for Young Children (Smart Start) . The grant award will allow the Health
Department in collaboration with the UNC School of Dentistry, to provide
dental screening, education, treatment planning, prophylaxis and referral
for approximately 1,500 children, age 0 - 5 in daycare centers, family
daycare homes, and health department clinics. The project will be
carried out during May and June, 1995.
BACKGROUND:
Last year, the Orange County Partnership for Young Children, the local
Smart Start board, awarded a grant in the amount of $29,575 for this same
project. The project involves using dental and hygiene students who have
completed their course work and are awaiting their board examinations to
screen, educate and arrange for the treatment of 0 - 5 year old children
in multiple settings. This work was carried out under the supervision of
qualified dental faculty and in collaboration with day care organizations
in the community. This low cost and effect approach screened 1,350
dentate children, 158 of whom ( 11.7%) needed care. Care was arranged
through private dentist, the Piedmont Health Services, the Health
Department and the School of Dentistry.
This year approximately 1,500 children will be screened and additional
funds have been provided to improve coordination and follow-up.
All of the cost of the project will be covered by the grant. No county
match will be required.
RECOMMENDATION(S) The Manager recommends that the grant award be
accepted as a grant project ordinance.
2
Orange County Partnership for Young Children `
Membership
January 27, 1995
John Walker,
President
Child Cue Resources Dr. E. S. Sandler
'Nsk FOCCe
Anita Daniels, Orange County Health Department Dental Program
,.
Vice-President P.O. Box 8181
Uaited Way of 300 W. Tryon St.
Greater Orange Co.
Marti Pryor-Cook; Hillsborough, NC 27278
Treasurer
Orange Co.Dept.of
Social Services Dear Dr. Sandler:
Sue Russell,
Secretary
Day Care Services Congratulations! You have been awarded an additional $32,890 in Smart Start
Ass°°uioa Grants for the Child Dental Screening Program from the Orange County
Brenda Breeze
Parent Partnership for Young Children. This grant is effective February 1, 1995 through
Jay Bryant June 30, 1995.
Curboro Alderman
Denise Conner
University United The OCPYC has proposed to the state that funding for this project flow directly to
Methodist
Richar E dwar& the Orange County Health Department through its existing contract. To complete
UNC School of this process, the Health Department must complete a revised budget amendment
Social Work
Ruth Edwards form using the current, most recently amended budget in the budget column. Also,
Edwards Day Can please complete the Project Title and Description Form, and the attachment form
Pam Evans that is the basis of our contract. This paperwork must be completed to initiate a
oPC Meal Health Y P P P
Center new project, and should be returned to us at your earliest convenience.
Sharon Freeland
Orange Congrega-
tioas in Mission Please be advised that the state contracting process could take several weeks, and
Bill Frenzel we encourage you to begin your project effective February 1, 1995. All funds
Orange County
Schools must be spent by June 30, 1995. We have been advised there will be no possibility
Ann Hart of carry forward funding. We hope that you can start your project before you
Chapel Hill-Carrboro
Schools actually receive the funds; please let us know if this presents any difficulty.
Beckie Hermartrt
O.C.Preschool Inter-
agency Council Please call me if you have any questions. Thank you fur all of your hard work for
versa Insko children and families in Orange county. We look forward to working together
Orange County
Cornm;«oner age!
Mike Mathers
Chapel Hill Training
Outreach Sincerely,
lim Protzman
FGI,Inc.
Amy Rabb
Child Care Networks
Dan Reimer
Orange Co.Health Michele Rivest, Executive Director
Department
Charles Sheaffer,MD
Chapel I-lill Pediatrics
X—cy Tapp
Cedar Grove Day
Care Center
Lynette Thompson
Parent
Michele Rivest
Esec uEive Director
110 W. Main St., Suite B, Carrboro, NC 27510 (919) 967-9091
3
ORANGE COUNTY PARTNERSHIP FOR YOUNG CHILDREN
SECOND ROUND SMART START GRANTS
SHORT-TERM SERVICE GRANTS
The goal of this project is to promote preventive dental health
education and identify needs and barriers concerning access to dental
care for children age 0-5 in day care centers and family day care
homes including: a) dental screenings , b) dental health education
to children, parents and teachers , c ) referral for dental treatment ,
d) follow up services for children screened who are in need of dental
treatment, and e) statistical analysis of the dental screenings .
Prior to the submission of this grant , the 199= Smart Start dental
screenings determined that there is need to promote preventive dental
health education and provide dental treatment to this population.
The Dental Service Grant would help to determine the number of
children needing dental treatment by conducting screenings in day care
centers and family day care homes . We will submit a plan in order to
provide the dental treatment for those children who have been screened
and need dental treatment but will have difficulty accessing it for a
variety of reasons . The Public Health Dental Hygienist can educate .the
pre-school teachers in "Dental Health Education Curriculum for
Pre-School Children" developed by the NC State Division of Dental
Health.
The critical need or problem facing young children and their
families is dental pain and infection . Preventive care such as topical
fluorides and sealants are not readily available to this population
because Orange County and surrounding cities lack available dentists
who will accept medicaid reimbursements .
During the past 15 years of operation, the Orange County Health
Department Dental Program coordinates an annual dental screening of
school age children. Many of the children screened live with dental
pain and infection so severe that both primary and permanent teeth are
lost because the dental decay is so extensive. Teachers , school nurses ,
and social workers report that children come to school for days and
weeks with toothache pain and dental infections . The parents send
their children to school with toothache medicine to get them through
the day trying to alleviate pain. The children can not learn in school
nor eat or sleep properly because of the pain . Parents need to be
educated about dental health before the children are even born and
throughout pre-school years to prevent tooth decay.
The funding from the Services Grant will pay the salary of the
project coordinators , senior dental and hygiene students screening
teams , data entry and detailed data analysis . Funding will also
provide for educational materials . From the screenings, the need for
dental education as well as treatment will be learned. Follow up
contact to the parent will be made via mail or telephone by the same
team which screened the child. This contact will determine access and
barriers to dental care . The Smart Start Committee will then determine
if dentistry is a priority health issue for this age group and whether
to support a planning grant which will provide funding for dental.
services for these Smart Start children.
4
INCREASING COLLABORATION WITH THE FOLLOWING AGENCIES AND GROUPS :
Child Care Networks and Day Care Services Association: would again be
utilized as valuable resources for communication and distribution of
Information . In addition to Child Care Networks and Dal,- Care Services
ssociation the Orange Countv Department of Social. Services and the
Chapel HilliCarrb(Dro and Orange County Schools will also be consulted
for input .
Day Care Providers : will be receptive to the dental screenings and
education component , communicate and help with parent involvement ,
help parents access dental treatment for the children. The day
care providers will be better educated in preventive dental health and
to the dental services available within the community to help
parents access care for their children .
Orange County Health Department: will provide the use of the
Hillsborough and Carrboro dental clinics as needed. The Dental
Director and Dental Program Coordinator of the Orange County Health
Department will be responsible for overseeing the Smart Start Grant ._
The OCHD Dental Hygienist together with the Public Health Dental
Hygienist will provide the teaching resources for the dental students .
and the dental hygiene students and be involved in instituting the
educational programs at the day care centers and the family day care
homes . They would also provide dental health education to Family and
Home Day Care Associations , write articles to be included in the
organizations newletters, provide educational materials to be
distributed for the organizations use.
UNC School of Dentistry: will provide dental students , dental hygiene
students, pediatric dental preceptors and coordinators . Teaching
dental students and dental hygiene students how to provide dental
services and become more aware of the dental needs of this age
population is a secondary goal . The grant should also be a source of
referral for those children needing dental treatment.
SPECIFIC OUTCOMES THAT WILL BE ACHIEVED ARE:
Dental Screenings would be available to children age 0 to 5
through Day Care Centers and Family Day Care Homes and children
not attending day care by informing the parents . The grant would
pay for contacting the day care providers to schedule screening
dates, conduct the screening and pay for educational supplies . The
dental screening would determine the number of children in the 0 to 5
age population needing dental treatment, the priority of the treatment
needed and determine access and barriers to dental care .
Dental Health Education Programs such as , prevention of
milk bottle tooth decay, diet and nutrition concerning dental health,
educating teachers in "Dental Health Education Curriculum for the
Pre-Schools" will be included in order to incorporate them into their
lesson plan .
Provide referrals for treatment for the children needing
dental care . Help parents access dental care according to the
dental needs of the children, financial considerations ,
transportation barriers , etc .
r
5
ADDENDUM TO THE BUDGET
FOR PROVISION OF DENTAL TREATMENT
If it is determined b%• the Smart Start Committee that payments
for dental treatment will be made available , the following is my
estimated cost and method for determination.
1 ) The 1994 screening survey determined that approximately
12 % of the children would need treatment ( 1350 dentate
children screened and 158 needed care = 11 . 7% )
2 ) we will assume that 1500 children will be screened in 1995
and that 12% will need care = 180 children .
3 ) Headstart approximates payments of $130 . 00 to $200 . 00 per
child for dental treatment .
4 ) Smart Start children include a younger age group who would
be more difficult and time consuming to treat.
.5 ) Many Smart Start children would not need funding as their
families tend to be insured or be able to pay for dental
care on their own.
For the above reasons , I estimate Smart Start would pay for
treatment for 100 children and it would cost $300 . 00 per child.
PROVISION OF DENTAL TREATMENT $30 , 000 . 00
r
6
(�_(� (� children at highest risk.
�C.— aGX�G The F(filled)component of the DMFS scores of non
Or, There Still are Many Children in white children is smaller than in white children for
Need of Dental Care every age cohort over seven years of age.
Guest Editorial More than 45 percent of black children and 39 percent
By H. Barry Waldman, B.A., D.D.S., M.Ph., Ph.D. of Hispanic children(compared to 15 percent of white
children) live in poverty. Despite a greater need for
• It's only natural to be proud of the successful comple- dental services,six million poor children have not seen
tion of some difficult task. We celebrate these events in books, a dentist in the past two years."
newspapers, even in professional journals. The successful ef- Black,and in particular, Hispanic children are less
fort to reduce pediatric dental pries is an example of a highly likely than white children to visit a dentist,even when
successful media event which has been reported ad nauseam in there are no socioeconomic differences between these
every conceivable lay and professional publication. groups. The frequently herd"no need"explanation
for not visiting a dentist suggests the necessity for an
Accomplishments intensive education program which would identify the
Many children begin school Erse of dries and an esti-
need for routine and preventive services!
mated 16 percent will graduate from high school without hav- While no national studies have been conducted to
ing had a cavity. determine the prevalence of dental disease among
4 Approximately 70 percent of school various special population groups(e.g.the develop-
mentally disabled)local and regional studies
age children have visited a dentist in the past indicate higher DMF rates among increasing
year. numbers of children receiving special educa-
More than 60 percent of children use If we are to provide for lion and related services(almost 11 percent of
drinking water that is optimally fluoridated the total number of children enrolled in pre-
another 10 to 15 percent use fluoride rinses the needs of the school through the 12th grade).'
or supplemental fluorides. underserved members Of
4 More than 90 percent of children our communities, we The economics of quality
brush with a dentifrice containing flouride.t must emphasize these The quality of care in a community is inexo-
continuin roblems to rably bound up with the funding for services. If
On the quality of care in your gp we are to provide for the needs of the underserved
community... the public and our legis- members of our communities,we must empha-
It's only natural to be proud of the lative representatives— size the continuing problems to the public and
extra effort we put into the pre we provide not just write about our our legislative representatives—not just write
each of our patients. The quality of pre for' about our accomplishments. Or are you so se-
the individual patient(Q for each individual) accomplishments. cure in the economics of your practice that you
is essential. But so,too,is the quantity of that can afford not to be bothered and continue to
care in our community(Q for quantity ofcare). provide care to just"usual"patients?
In determining the quality of tare in a com-
munity(Q for community pre),we must take note of the extent H. Barry Waldman is professor and chairman of the Depart-
of pre available for all residents in our communities,as well as ment of Dental Health, School of Dental Medicine,State Uni-
the quality of pre received by individuals. versity of New York at Stony Brook Stony Brook, N.Y.
The dental profession in general and pediatric den-
tists in particular have made significant strides in the care of References
youngsters in our communities. However,theft is a long way I Nowak,AJ.,Waldman,11.9.,Johnson,D.,McTique,D.J.,
to go before we can claim we are providing services for all young- cir Health Policy P. Pediatric Oft Health Washington.D.C.,center
far Health Polity Research of George Washington University,1993.
sters. 2 Brunelle J.A,Carlos,J.P. Recent trends in dental cries in U.S.
The latest national data indicates: children and the effect of water fluoridation.69(Spec Iss):72.3-727,
• One half of children are not caries tree. J Derr Res,1990'
3 tanait.A.L.Szpunar,S.M. The prevalence of total loss dental
Twenty-five percent of children have 60 percent of erica,and periodontal d"cease in Mexican Anmicu%Cuban
dental decoy. American and Puerto Ricans:fntding from IIIIANES 1982-1984.
• The mean DMFS rates for children's permanent teeth U.S. pplcrrmem 1183-1 ncr S 1 Pub Health 1990.
jX 4 U.S.Department of Commerce.Statistical Abstract oCthe United
progressively increase for each age cohort reaching States,1991.Washington.D.C.,Government Printing Office,1991.
8.06 for 17 years olds. S U.S.Deparunenl of Health and Flutnsn Service. Health Status of
Minorities and l.ow Income Groups.DHHS Pub.No.(LIRA)HRS
• More than 50 percent of U.S.adolescents have .P-DV a3-1. Washington,D.C..Governmrnt Printing Office,1985.
periodontal diseases. 6 GiIL S..Newman,J.F.Oral health activities of U.S.children:result of
• Prevalence of nursing caries ranges as high as 58 a national health interview survey.123:96-106,I Amer Dent Assoc,
percent in preschool children with Native Ameriain 1992
Southern Smiles Communicator, Vol. I No. 1,page 21
Ccntroctc OR-ANGE COUNT'i KEALTH 'D �aaTM�yT
'3tended/Leveraged Smart Start
coAL• ACTTVITY: Total Funds I Funds
Funds
Description Amount ; Arncunt
Amount
Psrsonnel
ScJcrv/Wa eslBeneftrs OQ.0 1
Professional Ser Acss
no
Board Membw CcmDer-ecMan
her
I
Tofaf Peraonnel SoMces $26,900.00
Su Res and Mctedcis I
Crflce suppoed and htcterlats i
'Compiter Supplies&Software
Janttcrlat Sup Ned
Educational/MedICCI Supplies
A(tMMCTNe Su lies
Cher.
Total Su ties and Materials $2,000.00 $2
f
Current abll aflons I
Travel
Communications(Telephone.Pceage,etc.)
Uttjtttes
Nntinc and Blndlnq
Repdr and Maintenance
Ccmputw SeMces(Acctin ou,etc.)
Empic
yee Training 200.00 20
Adverttsin
Board Member Expense rave(,Per Diem)
Other:
Other.
Total Current Obll aticns $700.00 $700-00
Fixed Cha es and Ex ones
OMce Rent(Land,Buildln ,etc.
Furniture Rental
Rental(Phone.Computer,etc.)
Vehide Rental
Dues and Subscrl tlom
lr=crce and Bonds
Omer: Overhpaa 2,900.00 T,9UU-
Tofai Fixod Chat es&Omer nses
ca ttdl CRMCY
Land/Buildings
Office Furniture
CompOor Egulpment 300.00 300-n(i
VehlCtes
Boole(IJbrcry Reteronce Materials)
Other.
Total Ccpffcl Outlay
Total Controcta and aranfs
Total Purchases of Services Costs
Total Budgeted Expenditures t32,890.00 R $327890.00
•P!GcSA Idanttty source or blended/leveraged tunc'!ng or,cn attached sheet.