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Dental Case Management: Improving Access to Dental Care for PLWH/A

Learn how the Dental Case Management program improves access to dental care for people living with HIV/AIDS (PLWH/A) in rural areas. Collaboration between community-based organizations, dental programs, and federally qualified health centers ensures comprehensive care for clients. The program provides services such as client recruitment, referral coordination, transportation assistance, and support in overcoming barriers to care. Dental Grant and RW Part B funding support the program.

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Dental Case Management: Improving Access to Dental Care for PLWH/A

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  1. ORALOregon Rural Alliance of Dental LeadershipJill Jones, BSDH, MS

  2. HIV Alliance • Community based nonprofit organization • Ryan White Case Management • Prevention & Education • Addition of Dental Program September 2006

  3. Program Model: Collaboration • Lane Community College • Dental Hygiene and Assisting Programs • Community Health Centers of Lane County • Federally Qualified Health Center (Tort Protection) • Regional Model • 15 county Service area • 5 mixed urban and rural • 6 rural • 4 frontier

  4. Client Demographics 15 County Service Area 718 PLWH/A 24% female, 76% male

  5. Clinics and Locations • Main Clinic: Clock Tower Dental Clinic at Lane Community College • Satellite Clinics-Currently Operation • Linn-Benton Community College in Albany • Central Oregon Community College in Bend • Satellite Clinics-Planned • Medford • Coos Bay

  6. Before Dental Case Manager Low client recruitment and retention No show rate 35-40% RWCM and clinic reception staff coordinate client access to clinics Clinical staff frustrated with lack of patients RWCM have limited time for client dental needs

  7. Development of DCM Position Minimal training was provided Individual hired previously worked as a Ryan White Case Manager Needed education and support around clinical dental aspects

  8. Activities • Recruits clients • Processing and tracking referrals • Collaborating with clients and RWCMs • Facilitates relationships • between clients, clinic and RWCMs • Arranging & providing transportation • Identifying client barriers and overcoming barriers • Clarifies system, minimizes conflicting information • Retains clients in care

  9. A Day in the Life of a DCM… • What does this actually look like • Receives referral by fax • Calls client to discuss needs and how to make an appointment • Provides clinic number • Helps coordinate transportation, lodging, etc • Provides transportation to and from appointment • Helps with any follow up needed

  10. DCM Services Provided • In Grant Year 3 • Coordinated 557 appointments • Provided 228 rides • Provided 43 meals • Helped coordinate care through • 212 clients received direct case manangement • 2,322 clinical services to 447 PLWH/A across more than 63,000 miles

  11. Clinical Services Provided • Grant Year 3 • 729 Diagnostic • 251 Preventative • 537 Restorative • 61 Endodontic • 256 Periodontic • 243 Prostodontic • 166 Oral Surgery

  12. Benefits for RWCMs • Decreases the workload for RWCMs • RWCMs have a contact for dental questions and issues • DCM helps reinforce the importance of dental care and medical care through the need for labs

  13. Outcomes • No show rate less than 10% • DCMs facilitate process with RWCM and clients ensuring follow through • Less burdensome to RWCMs, clients and reception staff • Clinician time is used more efficiently reducing frustration • Clients are able to contact one person to guide them through the system

  14. But Most Importantly… Clients are accessing care!

  15. How do you pay for it? Dental Grant pays for half Contract with State of Oregon RW Part B pays for other half Dental care is one of the core medical services under the Ryan White Care Act

  16. Conclusion • Prior to a DCM, getting clients into dental care was difficult • Isolated dental from case management; assigned one person to be the expert • DCM provides consistent messages to clients, RWCMs and dental clinic • One individual = accountable and reliable • Positive impact on clients, RWCM and clinic

  17. Contact Information Jill Jones Lane Community College JonesJ@lanecc.edu Amanda McCluskey HIV Alliance dental@hivalliance.org www.hivalliance.org/dentalclinic.html

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