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CDHC advances: Workforce model pilot project gains House support

San Antonio—Last month, the ADA House of Delegates registered its strong support for the development of the Community Dental Health Coordinator workforce model by committing up to $5 million to continue the CDHC pilot programs.

With its approval of Resolution 39H-2008, Delegates directed the Workforce Models National Coordinating and Development Committee to begin pilot testing the CDHC to evaluate the effectiveness of the model, while simultaneously identifying outside funding for the three pilot sites, project support, equipment and supplies. The resolution passed with 80.7 percent of the House's favor.

"That was very significant," said Dr. Bob Brandjord, the committee chair. "We are actively seeking outside funding from grant-making agencies and foundations for the pilot program, and potential funding sources want to be sure that the ADA members are behind it. This shows those funding sources that the ADA is serious about this concept."

Res. 39H also calls for an annual report to the House with a financial update on the CDHC pilot programs and an outcomes assessment when it is available.

Pilot testing the Community Dental Health Coordinator, in the works since 2006, can now begin. CDHCs in-training will work under the supervision of licensed dentists at three sites:

  • Rural site—University of Oklahoma with online curriculum by Rio Salado College and hands-on clinical training in Indian Health Service facilities and Federally Qualified Health Centers. The pilot program has been approved by the Oklahoma Board of Dentistry.
  • Native American site—Partnership between University of California-Los Angeles and Salish Kootenai College of Pablo, Mont., a tribal college on the Flathead Indian Reservation with a CODA-accredited dental assisting program. Online curriculum by Rio Salado College of Arizona and hands-on clinical training in Native American facilities in several different states.
  • Urban site—Michigan Coalition for Development and Implementation of the Community Dental Health Coordinators in collaboration with the Wayne County Community College District. Pending state approval, hands-on training will occur in Federally Qualified Health Centers.

After receiving the good news from the House of Delegates, the committee called a meeting with the pilot program representatives (scheduled for Oct. 30-31 at ADA Headquarters) to finalize plans.

"We're coming together now as a group to finalize, among other things, the program's structure and the application process for students wishing to become Community Dental Health Coordinators," said Dr. Brandjord.

Several new workforce models have been proposed to expand the dental workforce and oral health access. The ADA has developed and supported two models—the CDHC and the Oral Preventive Assistant, another new member of the dental team who will work primarily in private practices providing basic preventive services and enabling dentists and hygienists to focus on more complex care.

The unique value of the Community Dental Health Coordinator over all other proposed models, said Dr. Brandjord, is its focus on the prevention of dental disease.

"This concept speaks to the ADA's commitment to the public's oral health," said Dr. Brandjord, a past ADA president (2005-06). "It is only one part of the profession's response to dental access problems, but it has a great potential to provide for the unique needs of underserved populations."

The CDHC will work under a dentist's supervision, possibly under remote supervision, as a member of the dental team. Schools, community health centers, churches, senior citizen centers and Head Start programs are all health and community settings in which a CDHC may work.

They will be recruited from the communities to bridge the gap between local cultures and dental health care systems, navigate community members through the delivery system and help diverse populations overcome barriers that prevent them from accessing dental health services.

CDHCs will be trained to promote oral health and provide preventive services including screenings, fluoride treatments, placement of sealants and temporary fillings, and simple teeth cleanings (selective scaling for plaque-induced gingivitis) until the patient can receive comprehensive services from a dentist or dental hygienist. CDHCs will not excavate caries but could place temporary restorations in caries with a dentist's approval after the dentist has made a diagnosis.

Perhaps most notably, the CDHC will be in a position to link patients who would not or could not otherwise access care with health providers by coordinating the logistics of appointments and helping patients become eligible for charitable dental programs.

At the ADA Board of Trustees' request, Dr. Brandjord delivered a presentation on the CDHC pilot Oct. 17 prior to the Reference Committee on Dental Education and Related Matters.

"Dr. Mark Feldman (then ADA president) and I discussed the work of the committee, the history behind the CDHC and corrected some common misunderstandings," said Dr. Brandjord. "We also shared data on the pilot program sites to show that there were few, if any, dentists practicing in the locations where the programs will be tested. I think this gave everyone a more complete understanding of what the CDHC program is about and its potential impact on communities."

One comment on the floor of the House in support of the CDHC struck a chord with Dr. Brandjord. Dr. Ernest L. Garcia Jr., the immediate past president of the Hispanic Dental Association, announced at the House of Delegates that the HDA, National Dental Association, Society of American Indian Dentists and Children's Dental Health Project recently created the Multicultural Oral Health Alliance with the goal of advocating as a collective group for oral health issues affecting communities.

"We see the development of the Community Dental Health Coordinator as a tremendous first step in helping to eliminate health oral health care disparities in our communities," Dr. Garcia told the Delegates, speaking for the 13th District. "Obviously, it's not the only step that we have to take. We are happy that the ADA is taking this approach, and appropriating $5 million to get this going says a lot for the ADA."

To read more about the CDHC, visit www.ada.org/public/careers/team/cdhc.asp. Information on the Oral Preventive Assistant is at www.ada.org/public/careers/team/opa.asp.

Watch for updates on the rollout of the CDHC pilot programs in upcoming issues of the ADA News.