HRSA-HCFA Oral Health Initiative

By Candace M. Jones

The HRSA-HCFA Oral Health Initiative was inspired by the recognition that dental access is a problem for families enrolled in Medicaid and SCHIP. According to a 1996 Office of Inspector General report, only 18 percent of Medicaid children visited the dentist. A meeting in Lake Tahoe in June 1998 was the genesis of this initiative. It has resulted in an interagency agreement between the Health Resources and Services Administration (HRSA), the "access agency", and the Health Care Financing Administration (HCFA), the agency responsible for the public financing of Medicaid, Medicare, and the State Children's Health Insurance Program. The Interagency Oral Health Initiative aspires to eliminate access disparities and to advance the oral health of all Americans, particularly those most vulnerable due to age, income, race, or special needs. A three-part strategy was developed to–

• maximize the federal role in access to care,
  
• partner with the private sector and states, and
  
• maximize prevention through science transfer.

A team of Medicaid dental consultants at the central and regional levels, public health dentists, dental hygienists, and pediatric dentists has been instrumental in the activities of the initiative. Since its inception in 1998, the initiative has made a number of valuable contributions to oral health promotion, including–

• convening or encouraging 24 state coalitions or "oral health summits" that focus on access to care and the elimination of oral health disparities
  
• developing a home page (address located at the end of this article) that contains a Web based "tool box" for states and advocates to use in reforming dental programs. The tool box includes–
  • actuarial models
  • workforce models
  • geographic mapping
  • model contract language
  • policy briefs
• participationg in various aspects of the Surgeon General's work-shop and conference on oral health
  
• assisting with the development of the first Surgeon General's Report on the Oral Health of America
  
• raising the issues of oral health disparities and lack of access to care with the Secretary of Health and Human Services, resulting in a departmental oral health initiative

Through the various bureaus within the HRSA and through the operating divisions within HCFA, a new emphasis on oral health has been achieved:

• The Bureau of Primary Health Care has increased the number of providers and the number of community and migrant health care centers providing dental services.
  
• The Maternal and Child Health Bureau (MCHB) has actively focused on children and families through school-based sealant and fluoridation programs and increased training for dental and medical providers offering critical health services to young children and their families.
  
• HCFA has created a special technical advisory group to explore ways to improve the quality and quantity of services for low-income families in partnership with states. They have also initiated a research program on the cost-benefits of early prevention, and provided assistance to states on reforming Medicaid and implementing SCHIP dental programs.

The HRSA-HCFA Oral Health Initiative is eager to help promote regional and state activities that address the oral health of America's youngest children. A list of regional HRSA field consultants and pediatric dental consultants to the HCFA regional offices has been sent to each ACF Regional Office health liaison and QIC health specialist. Contact your Regional Office or QIC for more information on assistance available for your program.

For more information on the HRSA-HCFA Oral Health Initiative, go to the web at: http://www.hrsa.gov/oralhealth

Candace M. Jones is Deputy Director Program Operations, Division of Oral Health, Office of Health Programs, Dental Program, Indian Health Service, T: 301-443-1106; E; jonesc@hqe.ihs.gov.

 

"This unique gathering of Head Start staff and parents, dentists and other health care providers, representatives from Medicaid and WIC, researchers, and others is an opportunity to explore new ways of working with partners to tackle issues of access to health services."

Tom Schultz
Director of Program Operations
Head Start Bureau