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Bill would extend funding for dental public health programs

February 06, 2019

By Jennifer Garvin

Washington — The ADA is thanking the Senate Committee on Health, Education, Labor and Pensions for introducing legislation that would extend funding for Community Health Centers, Teaching Health Centers and the National Health Service Corps through 2024.

In a Feb. 1 letter to HELP Chair Lamar Alexander, R-Tenn., and Ranking Member Patty Murray, D-Wash., ADA President Jeffrey M. Cole and Executive Director Kathleen T. O’Loughlin thanked the legislators for recognizing the role that these programs play. S 192, the Community and Public Health Programs Extension Act, was the focus of the committee’s Jan. 29 hearing, Access to Care: Health Centers and Providers in Underserved Communities.

“A qualified and culturally competent workforce is vital to meet the nation’s changing health care needs. Continued funding for Community Health Centers, Teaching Health Centers, and the National Health Service Corps are important to the nation’s health care infrastructure,” Drs. Cole and O’Loughlin wrote.

Today’s dental education engages dental students in community-based programs for a significant part of their training so that future dentists are able to learn the value of medical-dental collaboration and culturally competent strategies to reduce dental disease in vulnerable populations.

“Community health centers provide necessary care to vulnerable populations, including uninsured individuals and those enrolled in Medicaid. Many community health centers have dental clinics or work with dentists in their communities to ensure that necessary dental services are available to patients seeking care,” Drs. Cole and O’Loughlin said.

They noted that the Health Resources and Services Administration supports the operation of nearly 1,400 health centers nationwide and community health centers serve as integrated health care homes for more than 28 million patients. According to the 2017 Uniform Data System, more than 15 million patient visited community health center dental programs.

Drs. Cole and O’Loughlin also highlighted the ADA’s Community Dental Health Coordinator program. CDHCs are now working in 39 states and provide community-based prevention, care coordination and patient navigation to connect people who typically do not receive care from a dentist in underserved rural, urban and Native American communities.

“The use of CDHCs to reduce oral health care disparities among underserved populations has begun to become evident in health centers,” Drs. Cole and O’Loughlin said. “These specially trained dental team members are promoting prevention of dental disease while connecting patients to existing, but underutilized, sites of care.”

One example where a CDHC program is making inroads is in Sen. Alexander’s home state of Tennessee. According to self-reported data from a Central Tennessee community health center, CDHCs helped more than 1,000 underserved seniors attain access to dental services. Another CDHC working at a community health center medical office helped increase the number of underserved patients seen in a nearby dental clinic by 300 percent, Drs. Cole and O’Loughlin said.

Getting patients out of the emergency rooms for dental pain and helping them find permanent dental homes is another benefit to boosting funding for community health centers, the letter said.

“Because patients in dental homes receive targeted treatment to alleviate rather than manage the causes of their oral health issues and pain, [emergency department] referral contributes positively to reducing opioid abuse,” said Drs. Cole and O’Loughlin, who noted that in 2015, there were 2.2 million visits to hospital emergency departments for dental conditions, at a cost of $2 billion.

Both CDHCs and the ADA’s Emergency Department Referral are key components of the ADA’s Action for Dental Health initiative. ADH is a nationwide, community-based movement aimed preventing dental disease before it starts and reducing the proportion of adults and children with untreated dental disease. In 2018, the Action for Dental Health Act — which was supported by the HELP Committee — was signed into law.

The National Health Service Corps is a successful scholarship and loan repayment program designed to strengthen the primary care workforce. The ADA supports renewed funding for the NHSC, which has supported the work of over 1,500 dental professionals in communities with limited access to dental care.

Teaching health centers support new or expanded primary care medical and dental residency programs in a community-based ambulatory patient care setting. Using statistics from HRSA, Drs. Cole and O’Loughlin noted that dentists and physicians trained in health centers are “more than three times as likely to work in a health center and more than twice as likely to work in an underserved area. Continued funding for this program would help strengthen these efforts and train more dental residents in medically underserved communities.”

“Thank you again for your commitment to the providers and health centers that help the underserved through the ADA Action for Dental Health,” concluded Drs. Cole and O’Loughlin.