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S.C. referral program helps guide patients to dental homes

August 08, 2016

By Michelle Manchir

Leaning in to help others: Dr. Joe Carlisle is the director of the Renew Our Community dental clinic in South Carolina, that has helped 900 people get dental care since its launch in 2015.
York County, S.C. — Renew Our Community is a nonprofit here that for years had been helping provide housing, meals, transportation and clean clothes to the underserved when its leadership in 2014 discovered another necessity thousands in the county had been going without: dental care.
The Renew Our Community Dental Initiative launched last year thanks to a collaboration between the organization, the local hospital, local churches and other service agencies and volunteers. Since then, almost 900 people who initially sought treatment for toothaches and other dental issues at the Piedmont Medical Center Hospital Emergency Department have received referrals to ROC Dental, which in turn connects patients with local dentists, surgeons and hygienists for definitive care, including access to denture services, along with encouragement to establish a dental home relationship.
"For the first time in their lives, some people are finding a dental home for sustained dental care," said Dale Dove, who launched Renew Our Community in 2011 as a general social services agency.
Mr. Dove estimates there are about 40,000 adults in the county of about 270,000 without access to dental care. The need became clear at a  2014 South Carolina Association Dental Access Days event, he said, when more than 1,400 came out for dental care in a period of 26 hours.
At that time in the community, "The few agencies in the area providing dental services for under-insured adults had specific eligibility criteria, provided minimal services, and there was no collaboration between the agencies," he said.
Mr. Dove, an attorney who has lived in York County all his life, found a willing collaborator in the local hospital's emergency department. Missy Breeden, a nurse navigator there, said the ED would regularly see repeat patients seeking help with dental issues — some coming five or six times.
"Prior to us working with ROC, most of the folks who came into the ED for toothaches couldn't get into any type of dental practice because even if they had Medicaid, lots of places wouldn't accept Medicaid. This program has given them a place to go and actually have dental treatment," Ms. Breeden said, adding that this method also helps circumvent opioid abuse among some ED patients.

One happy patient: Judy Latham, shown before and after treatment thanks to the Renew Our community Dental Initiative, is among the hundreds who have gotten dental care thanks to the program.
Here's how the referral system works: Patients who come to the ED needing dental attention are given a voucher and the responsibility to make an appointment to the ROC Dental clinic. Transportation is offered if they need it — and the nonprofit asks for a $20 copay if the patient can swing it. Also, the program, thanks to volunteers and staff, helps patients sign up for Medicaid if they qualify.
"We take away every excuse the patient may have not to come to their appointment," Mr. Dove said.
Paying the approximately 40 network dentists, at least at Medicaid rates, is a priority, too, Mr. Dove said. The majority of participating dentists treat patients in their own offices, but patients are also managed in a separate, freestanding clinic.  Here, they are provided more complicated surgical treatment under the care of the clinic director, Dr. Joseph Carlisle.  Dr. Carlisle oversees the clinic activities, working closely with the dental program director, the Rev. Jean Wrenn Roach. The program's denture team, and dentists and hygienists who provide patient treatment in the evening, also use the clinic.

In addition to using grants and donations to cut the paychecks, the ROC organizers are establishing a microloan program with a local bank, wherein borrowers can pay back their low-interest dental loan in monthly $20 increments — or whatever amount they can afford.  "We don't want it to be a total handout," said Ms. Breeden. "They should have some responsibility if they are financially able."  However, no patient in pain is ever turned away for lack of financial assets.  

Organizers acknowledge there are challenges — especially in keeping the program fully funded and collecting payments from clients — but that the heartrending stories they hear from patients keep them going.

Dr. Bill Cranford, who has been involved in the program as a dental provider since its inception, recalled two patients who, because they received new dentures, were able to get better-paying jobs because of their new appearance and confidence.

Dr. Cranford said he appreciates that he can help the patients while also working in his own office with his staff and supplies and equipment.

Eventually, Mr. Dove said he hopes to make the dental services available to the public and not just those who visit the ED. The whole point of his aptly-named nonprofit is to "renew the community."

"The goal of Renew Our Community and the ROC Dental initiative is to mobilize the community to renew broken lives and build up our entire community," he said. For more information about the nonprofit, visit its website, RenewOC.org.