Feedback on the Forum

By Judy Pulice

They say you are never too old to learn. Although some days it seems I am, that was not the case when I attended the Oral Health Forum last September. In fact, I learned a lot about oral health during that day and a half.

First I had to throw out some of my misconceptions, developed nearly 25 years ago, of how Head Start programs operate and how local programs fit with state and federal activities and oversight. Second, and most importantly, I had to learn what is not working when it comes to oral health and treatment for Head Start children.

Head Start is not unique in its attempts to deliver dental care to poor children, especially those between the ages of two and five. The basic problem encountered is the inadequate Medicaid dental programs in most states. Funding is often inadequate, the forms are cumbersome, and the policies do not make sense to most dentists. Additionally, in a majority of programs, the reimbursement rates do not come close to covering the costs of providing the services. We can see why a great many dentists have discontinued participation.

During the Forum, Head Start program staff expressed their frustration and even anger at dentists in their communities who are unwilling to treat these vulnerable children. I understand and empathize with Head Start staff. I also, however, understand and empathize with the dentists who are no longer able to participate in a program that is, it seems to them, beyond repair. Members of the American Dental Association often express their frustration and anger at state legislators and officials who consistently underfund their dental programs, either because they do not believe dental care is essential to a child's well being, or because they feel other services have priority.

At the end of the Oral Health Forum, after meeting and talking with so many program staff and federal coordinators, I knew that not only had I learned something, but so had the other participants. Though they still seemed frustrated and angry, they promised to return home and contact the local or state dental society to see if they could work together to make a change in the attitude of policymakers. I hope they followed through. The theme at several "access" conferences lately has been community collaboration; it will take contributions from all stakeholders to make the significant changes needed. I am hopeful, in the case of oral health, we can work together to make the necessary changes.

Judy Pulice is Director, Department of State, Government Affairs, American Dental Association, T: 312-440-3520.

 

"This was the first time that these federal agencies (Head Start, USDA, HCFA, and HRSA) got together to try to eliminate the barriers to oral health care for low-income families. The development of the papers and the real world response from parents and program staff will help us deliver coherent messages to families and programs that can be effective."

"I was very impressed by the knowledge of the Head Start community about oral health."

"The partnership has a lot of potential. Certainly some work is going on at the regional as well as national level. Materials are being produced for use by local programs. We are working hard on improving the access to dental care through Medicaid. The personal connections among the partners should not be underestimated. We value the expertise and commitment of all the partners and continue to review each other's work and ask for advice. Head Start has a lot to offer the dental community."

Donald Schneider, DDS, Chief Dental Officer for Health Care Financing Administration.