Questions 3 and What Organizations Have Done to Address Workforce Issues and Their Impact amsa



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Questions 3 and 4. What Organizations Have Done to Address Workforce Issues and Their Impact



AMSA

  • 3 meetings and several workshops on dental public health, “widening the pipeline”, and community health centers.

  • public health leadership seminar series for dental residents and faculty members—fund 20 pairs per year

  • we just began these efforts this year so we don not know their impact yet



OHA


  • Indirectly affected issue by raising awareness among policymakers, funders, opinion leaders, public

  • Have reached over 50% of American households with oral health related news stories



NACHC


  • Worked over the past five years to secure federal funding to double the size of the National Health Service Corps Program, and to preserve and expand the J-1 Visa and Conrad-30 programs (these programs support general dentistry)

  • Worked in coalition with provider, public health, and other advocacy groups to increase support for Title VII programs

  • Consistently offered educational sessions at our conferences focused on workforce needs and on oral health care issues

  • Staff have also worked with a range of dental health organizations, including the American Dental Association, the American Dental Education Association, and the Children Dental Health Project to raise awareness of dental health workforce needs and the need for increased access to dental care in underserved communities

  • In the process of revising our issue brief on oral health care issues.

  • All of the activities have had great impact in advancing workforce and oral health issues. For example NACHC, along with the ADA, provided significant input into a handbook for health centers on contracting for dental health services that can be accessed at http://www.cdhp.org.

ACU


  • Attended conferences

    • National Oral Health Conference(s) AASTDD/BPHC

    • AAP-AAPD Children’s Oral Health workgroup

    • Interface Meeting

  • Developing ACU/ECC Advocacy Policy Brief

  • ACU Oral Health Website PP(s)

  • ACU/ECCP Listserv

  • RWJ webMethods Foundation, others pending

  • Transdisciplinary Hands-on Workshops ECCP – Evaluation report of this project


UCSF-CHP

  • See separate listing of articles/reports

  • Attend and present abstracts at AAPHD/ASTDD annual conference, Academy Health annual research conference, HRSA regional meetings, APHA meeting

  • Participate in state coalition on access to care, attend annual state meetings on dental workforce and services

  • Member of AAPHD subcommittee on workforce

  • Received the following funding:

    • HRSA funding to look at the dental public health workforce in California as part of a national project;

    • HRSA funding for the Center for California Health Workforce Studies that funds ongoing studies of the dental workforce

    • California HealthCare Foundation funding to examine access to dental care in CA

    • NIH funding to develop a survey of RDHs in California

  • Many of our research reports have been cited widely, including in California legislation and in lawsuits against Medi-Cal. Our staff are asked to present findings and provide technical assistance to efforts nationwide. All of our reports are available on our website, http://futurehealth.ucsf.edu.



State Medicaid Directors


  • We are just in the process of organizing a new organization of state Medicaid dental program representatives. For the past several years, we have addressed workforce issues primarily through state reps attendance at conferences and participation in the Kids Oral Health and Dental Public Health listservs. Within our own organizations (state Medicaid agencies), there have been a variety of workforce mechanisms used to try to increase access to dental care for Medicaid beneficiaries, including increases in reimbursement, reduction or removal of administrative barriers, use of dedicated clinics, tax incentives, pay differentials, use of expanded function ancillary dental staff, etc. Although a number of activities have had a measurable impact on access to dental care for Medicaid beneficiaries, the effect on the dental public health workforce is unknown.



ASTDD


  • Co-sponsor annual National Oral Health Conference

  • Adopted National Call to Action

  • Partnership Network with many other organizations as part of cooperative agreement objectives and ASTDD strategic plan

  • Have a Leadership Committee that created DPH Leadership Development Initiative Plan; this activity is funded through the HRSA cooperative agreement

  • Partnering with ADEA to promote dental /dental hygiene curriculum on public health careers

  • Participated as an invited partner in a HRSA-funded project on public health workforce through SUNY Albany School of Public Health. Report is due in early 2004.

  • ASTDD established a mentoring program for new State Dental Directors and has provided mentors for these individuals since 2001.

  • Website www.astdd.org and member list serve

  • Infrastructure document (see publication list and also on the website) resulted in federal funding through CDC and the development of performance standards for 13 state oral health programs.

  • Submitted grants to fund this Workforce workshop, which will have impact.



AADR


  • AADR members have participated in task forces studying workforce issues. Our emphasis has been on the research workforce. IADR/AADR core activities focus on providing professional meetings for the dental research community and publishing journals that describe dental research, including findings in DPH. The IADR scientific group, Behavioral Science & Health Services Research (BSHSR) contains many members who are active in DPH and DPH organizations, such as AAPHD, APHA (Oral Health Section), ASTDD and others. A link to our meeting abstracts and the BSHSR web site is available from www.dentalresearch.org .

  • Unsure if there have been symposia or journal issues on this subject.



AAPHD


  • Annual AAPHD/ASTDD/National Oral Health Conference

  • Attendance at the ADA meeting as a mid-year meeting for the executive committee of AAPHD; collaborations with NDA, HDA.

  • dental-public-health listserv – instructions to join found on the “about AAPHD” page of the AAPHD website www.aaphd.org

  • The AAPHD “Strategic Action Plan” is available from the organization’s web page at www.AAPHD.org; Too soon to have any measurable impact.



ADHA


  • Several of the states with enhanced practice acts are beginning to see some progress in terms of dental hygienists providing services; e.g.. Washington, Connecticut; 10 states now directly reimburse dental hygienists through state Medicaid programs.

  • We are currently in the process of obtaining speck information (and in the long­term, data) on what dental hygienists are doing in public health settings or other areas besides the private practice dental office (schools, nursing homes, community settings, etc.).

  • ADHA has a public health council and also holds a networking session on public health every year at our annual meeting.

ASTHO


  • Currently working on an issue brief on public dental health workforce in collaboration with ASTDD (planned release prior to the meeting). See chart for additional activities.

  • Founding partner of annual workforce development meetings

  • Survey developed with ASTHO affiliates on current condition of workforce. (Currently in field)

  • Developed web site for public health workforce development collaborative to list of activities of all members

  • Staff public health workforce development

  • Partnership with National Association of State Personnel Executives (NASPE)



CDHP


  • Interfaces Invitational Meeting – to expand the dental public health workforce to include non-dental providers

  • Presentations on the dental workforce at national meetings including 2002 NOHC, NACHC

  • Technical assistance to Congressional offices on dental workforce legislation

  • Numerous meetings with child health advocacy organizations to educate and engage them in the issues of the dental workforce

  • CDHP’s Fellowship for a dentist to learn pediatric oral health policy

  • CDHP’s Health Services Research Award

  • News*Bytes (archives available at www.cdhp.org; subscription to listserve available from Mike Ambrose at CDHP mambrose@cdhp.org).

  • Numerous meetings with child health advocacy organizations to educate and engage them in the issues of the dental workforce

  • See papers in separate list



NACCHO


  • We host an annual conference in addition to topic specific trainings throughout the year. These help to strengthen the knowledge of the PH workforce on current issues and concerns.(Info at www.naccho.org)

  • NACCHO maintains a website and several listservs that are used to announce trainings that will bolster the PH workforce.

  • In Fall 2003, NACCHO hosted an audio conference highlighting programs in local public health agencies that focus on oral health.

  • We have an evaluation of the Oral Health Audio Conference (that we will bring to the February meeting.



NCSL


  • Hosted a conference called Tools to Improve access to Oral Health in Minneapolis in June of 2002.

  • Survey and report on Improving Dentists’ Participation in Medicaid in 2001; did surveys in 1998 and 2000 on participation (see separate list).

  • Report for RWJF on Access to Oral Health Services for Low Income People in Oct. 2002.

  • Received a grant from Kellogg to write a paper on racial disparities in oral health (including workforce)

  • Member of Ad Hoc Advisory Comm. on African Americans’ oral health, org’d by the Jt. Cntr for Pol. And Econ. Studies

  • There are no funds to evaluate impact for grant deliverables beyond things like meeting evaluations, which were positive, and critical feedback, which has been also.

CDC

  • Fund portions of NOHC

  • Conduct workshops for supported states

  • Staff served on an AAPHD/ADHA task force to consider mentored post-MPH experiences for RDHs.

  • Supported ASTDD in creating infrastructure and capacity report.

  • Support 1 DPH resident/year.

  • Fund state programs to hire DPH trained staff.

  • Support interns and fellows at DOH.

  • PHPPO study of barriers to utilizing workforce fully per state law/regulation changes.

  • PHPPO has developed National Public Health Performance Standards, including assuring a competent PH workforce.

  • CDC has supported Council on Linkages (academia and PH practice) identification of core competencies for PH professionals.

  • Website provides access to principles of DPH practice

  • ASTDD Infrastructure and Capacity Report lead to structure of CDC program to support state dental disease prevention activities.

  • CDC program to support states has increased DPH positions in SHAs, including those for other PH disciplines applying their skills to OH.

  • DOH program hasn’t been supporting these activities long enough to have a measurable impact.



RWJ Pipeline Project


  • The Pipeline program has made a major effort to change dental education to deal with several key dental public health issues. These include:

    • Increase access to dental care for underserved populations.

    • Provide dental students and residents a greater understanding of public health and cultural competency knowledge and skills.

    • Increase the number of underrepresented minority and low-income students in the dental profession.

Within this framework the Pipeline programs has made large investments in all six activities listed in the table on the survey under the Dental Public Health Workforce.

  • The Pipeline program has had a measurable impact on all six areas, and there is a wealth of evidence to support this conclusion.



SCD


  • SCD has an annual session with major programming in policy and advocacy and training for practitioners in providing dental services to people with special needs.

  • SCD has produced and contributed to a number of policy papers and reports in this area. See Web site at http://www.scdonline.org/

  • SCD has partnerships in past and in progress with a number of organizations to promote oral health and well being for people with special needs. Partner organizations include ADA CAPIR Council, Oral Health America, American Dental Hygienist Association




  • SCD recently responsible for Senate forum on Oral Health and Aging. See SCD web site at link above.

  • Sorry – no measurable or documented impact at an organizational level although individual members have projects with measurable impact.



VIH


  • Volunteers in Health Care has conducted its oral health activities in four ways: 1) making grants available to support dental health services, and collaborations; 2) producing manuals and case studies related to starting dental programs and recruiting dentists to participate in access initiatives and activities in their communities; 3) serving as a national voice on issues related to dental access and the need for increased attention to be given to oral health and the link between oral and medical health care; and 4) providing one on one technical assistance for organizations and communities looking to start or expand dental health services. VIH resources are available on our website, at www.volunteersinhealthcare.org

  • We have heard anecdotally that our grants and manuals/case studies have been very useful. We have heard from several applicants who did not receive grants that the experience of bringing together community players to submit an application generated opportunities and dialogue that otherwise would not have occurred.



NNOHA


  • Annual conference sponsored primarily by HRSA BPHC, NNOHA and others

  • NNOHA listserv for dental providers in community, migrant and homeless health centers and other members of NNOHA

  • Advocate for increased access to dental services for unserved and underserved populations

  • In CHCs a lot is being done to address workforce issues. We have advocated for:

    • expansion of CHCs

    • increase in NHSC loan repayment and scholarships

    • increased involvement with dental schools

    • administratively mandating that oral health services must be provided in new health centers. Also pushing to get dental into existing sites without dental

  • Measureable impact has been seen in:

    • Increased dental programs in CHCs

    • increased dental providers in CHCs

    • increased NHSC loan repayment for DDS, RDH

    • oral health mandated in new CHC starts



IHS


  • Attend, speak at and sponsor national meetings

  • Released IHS Director’s Oral Health Initiative

  • Released findings from 1999 HIS Oral Health Survey

  • Participated in creation of Surgeon General’s Report on Oral Health

  • Newly created IHS recruitment website and creation of recruitment materials in hard copy as well as electronic format

  • Creation of IHS DOH listserv and co-sponsored creation of USPHS listserv and USPHS Bulletin Board

  • IHS HQ Division of Oral Health has sponsored several programs and initiatives

  • Anecdotally, the Clinical and Preventive Support Centers have assisted with the supplementation of administrative resources which were once, but no longer, available from the IHS headquarters Division of Oral Health. While we have lost our Headquarters West staff and 40% of our Headquarters East staff, due to resource constraints, the CPSCs have helped to rebuild some of the dental public health resources we once had.



CMS


  • (Participation in various activities, but no specific given)

  • Solutions developed in numerous state dental summits have been reported to have had a significant impact on dental provider participation in Medicaid and SCHIP, but this may not impact the dental public health workforce directly.



HRSA


  • Joint funding of National Oral Health Conference (HRSA/MCHB)

  • Fund Leadership Centers for Training in Pediatric Dentistry (HRSA/MCHB)

  • Dental Public Health training (HRSA/BHPr)

  • Fund State Oral Health Summits

  • Fund Regional and State Head Start Forums

  • Fund Title V Block Grant Program (HRSA/MCHB)

  • Fund State Oral Health Collaborative Systems Grants (HRSA/MCHB)

  • Fund State Oral Health Integrated Systems Development Grants (HRSA/MCHB)

  • Fund Partnership for State Oral Health Leadership Cooperative Agreement to ASTDD (HRSA/MCHB)

  • Fund Community Oral Health Programs and Health Centers (HRSA/BPHC)

  • Fund National Primary Oral Health Care Conference (HRSA/BPHC)

  • Oral Health Best Practices database (HRSA/BPHC)

  • Fund National Health Service Corps (HRSA/BHPr):

    • Ambassador, Scholarship and Loan Repayment Programs

    • Dental public Health Shortage Area Designations

    • Ready Responders

      • Ryan White CARE Act Dental Reimbursement Program (HRSA/HAB)

  • Various legislative earmarks funding community oral health programs (HRSA/Office of Rural Health)

  • Children's Oral Health (Closed) Listserve (HRSA/MCHB)

  • National Maternal and Child Oral Health Resource Center Web Site (HRSA/MCHB)

  • National Oral Health Policy Center Web Site - in development (HRSA/MCHB)

  • Developed web site for public health workforce development collaborative to list activities of all members

  • Staff to public health workforce development

  • Partnership with National Association of State Personnel Executives (NASPE)

  • Federal grant programs to States, cooperative agreements and contracts.

  • White papers (HRSA/MCHB):


ADEA (ADEA can provide more details of all initiatives)

  • Implement $1 Million Access to Dental Careers (ADC) ADEA/W. K. Kellogg Grant. This grant will provide direct educational assistance to predoctoral and postdoctoral students.

  • Minority Dental Faculty Development Program. The W.K. Kellogg Foundation recently announced that it is awarding the American Dental Education Association $2,408,127 over a six year period to promote health systems change that is focused on primary care, prevention and public health by building a network of universities and organizations focused on developing health leadership.

  • Produce Student Manual. Opportunities for Minority Students in U.S. Dental Schools (OMSUSDS). The fourth edition (2003-2005) of OMSUSDS has been released. Copies have been sent to the 56 U.S. dental schools. The Office of Minority Health/HRSA has purchased 500 copies of the resource manual for distribution to its federally-funded minority-targeted programs.

  • Implementation of the Second International Women’s Leadership Conference, Göteborg, Sweden, June 20-23, 2003. This highly successful conference had as its theme: Global Health Through Women’s Leadership.Proceedings will be published as an addendum to the Journal of Dental Education.

  • Sixth Regional Predental Advisors Workshop. Planning is underway for the sixth workshop that will be held in conjunction with the 81st Annual Session and Exposition in Seattle, WA. The program model will be enhanced to address the needs of the emerging majority populations in the western region: Asian Americans, Native Americans and Hispanics. Invited participants are officers from the 56 U.S. dental schools, pre-professional advisors from the feeder schools in the Western region, and local high school guidance/career counselors. College advisors and high school counselors will be invited to bring students that have expressed interest in the health professions. Partial support for the workshop is received from the Procter & Gamble Company.

  • National Dental Association Faculty Forum. The NDA Education Committee and the ADEA Minority Affairs Section jointly sponsored this forum, Priming the Pipeline II: Recruiting Dental Professionals for the Future, at the NDA Annual Convention. The convention was held in New Orleans, August 1-6, 2003. ADEA also assisted in the NDA/Colgate Minority Faculty Awards program that recognizes minority faculty achievement in the areas of teaching, research and service. Awards of $750 each were presented.

  • California Endowment. Dental Pipeline Initiative. ADEA has received a grant award of $500,000 from the California Endowment to enable the addition of 4 new California dental schools to the Pipeline/Access to Dental Careers awardees. The award is through the Trustees of Columbia University in the City of New York, Center for Community Health Partnerships. The five California schools will receive $25,000/year each for four years.

  • ADEA Presidential Task Force on Access. In 2001 ADEA Past President Pamela Zarkowski created a special President’s Commission on Access which brought together an ADEA President’s Commission of National Experts to explore the roles and responsibilities of academic dental institutions in improving the oral health status of all Americans. The Commission issued the report entitled, Improving the Oral Health Status of All Americans: Roles and Responsibilities of Academic Dental Institutions. The commission made a variety of policy recommendations, including a Statement of Position, approved by ADEA’s House of Delegates in 2003.

  • ADEA Legislative Advocacy on Workforce Issues. All legislative and advocacy activities are under the auspices of ADEA's Center for Public Policy and Advocacy (CPPA) The CPPA is advised by ADEA’s Legislative Advisory Committee which makes recommendations to the ADEA Council of Deans and Board of Directors. Most notable advocacy efforts occurred around:

    • Dental Health Improvement Act.

    • Reauthorization of the National Heath Service Corps (NHSC).

    • Children’s Dental Health Improvement Act.

    • Other Legislative Efforts are covered in various fact sheets and talking points prepared by CPPA staff for information on other ongoing ADEA legislative efforts to achieve adequate funding for an array of programs that augment the dental public health workforce.

      • Advocacy days in Washington where our deans and members advocate on Capitol Hill for ADEA legislative priorities. This year, we had approximately 70 participants who scheduled more than 90 Hill visits. This year’s focus was on preserving the Dental GME program’s non-hospital based dental residency training programs.



NRHA


  • We are holding a meeting this year on rural oral health

  • We have a policy brief at http://www.nrharural.org/pagefile/policybriefs.html



NIH


  • CDO, USPHS is also deputy Dir, NIDCR. She has developed several initiatives that have implications for dph workforce that is geared to recruiting individuals esp minorities.

  • Commissioned a report on dental public health infrastructure. Coordinates the National Call to Action to Promote oral Health, which includes need for enhancing the oral health workforce capacity including dph.

  • Funds dental public health residencies; summer dental students; DDS/DMD-PhD programs; loan repayments; long and short term research training for dental students, DDS, DH’s & PhDs in areas related to dental public health. E.g. epidemiology, biostatistics, behavioral and social sciences, health services




  • Dental Public Health Residencies: increased # of DDS eligible for dental public health board

  • DDS/DMD-PhD program: increase # of DDS with PhDs who will pursue a career in dental public health research

  • Summer dental student: increase # of dental students interested in dental public health as a career



ABDPH


  • Representatives at Dental Public Health residency directors’ workshops, which have included presentations about dental public health workforce issues

  • Annual Board symposium periodically has presenters who address issues relating to the paucity of public health professionals

  • Currently, ABDPH is in the process of a document that provides a historical perspective of the Board from early 1980s through 2003.

  • Submission of report on the status of the specialty of Dental Public Health to the American Dental Association (2000)

  • ABDPH portion of AAPHD website includes names of all diplomates

  • Annual report to American Dental Association concerning numbers of diplomates in the specialty

  • ABDPH and its sponsoring organization, AAPHD, develop, periodically review and revise competencies in dental public health. In that regard, competency V (evaluate and monitor dental care delivery systems) includes a section concerning “evaluating changes and trends in demographics, health status, risk factors, utilization of services, dental personnel, structure of delivery systems, financing, regulations, legislation, policies”. Hopefully, there is some indirect effect of having such a statement and the monitoring of the dental workforce, including the specialties.



ADA


  • Gather workforce information on a regular basis

  • Interact with federal and state agencies

  • Advocate with US Congress for support of public health workforce and budgets

  • Workforce conferences held periodically—latest one on dental faculty and education

  • Special report on dental auxiliary workforce (2000)

  • Dental workforce report to ADA trustees—periodic

  • Public information on ADA website

  • Develop career guidance information: educational materials for prospective students and guidance counselors; traveling displays for career days

  • Dental economic advisory committee studies workforce issues periodically; last was 2002-03

  • Impact: 1) advocacy—PH budgets have been pretty much maintained; 2) ADA has become credible source of most comprehensive information on workforce issues


AAP

  • Annual AAP National Conference and Exhibition: Training Physicians in Oral Health Risk Assessments Workshops

  • Continuing Medical Education

  • Oral Health Preceptor Training Awards

  • Oral Health presentations at Chapter Meetings

  • Oral Health presentations at CATCH meetings

  • 2004 Oral Health Resolution

  • Bright Futures Oral Health materials

  • AAP News Recent Articles

  • Pediatrics Recent Articles

  • Children’s Oral Health Initiative Listserv ®, Section on Pediatric Dentistry Listserv ®, Section on Pediatric Dentistry Web site http://www.aap.org/sections/peddentist/PDdescription.htm, Coming soon: PedsCare Oral Health Web site

  • PedsCare Oral Health Preceptor Awards

  • PedsCare Oral Health Educational Grants

  • Oral Health CATCH Grants

  • Oral Health Healthy Tomorrows Partnership for Children Grants

  • In development through PedsCare Oral Health Initiative:

    • Training Pediatricians in Oral Health Assessment (training modules)

    • Oral Health Assessment Tool Kit



HispDA


  • HDA conference 2002- 2003

  • 2002 article on Hispanic dentists—see other list


CHCS (RWJ Access Prog)

  • The Robert Wood Johnson Foundation (RWJF) has been focused on the issues of workforce in health care for close to 20 years and offers forums for leadership development and training. RWJF did provide a specific scholars program for leadership development for oral health professionals; however that program is no longer available. However, applications to the following programs are available to any health professional; The Robert Wood Johnson Health & Society Scholars Program; State Health Leadership Initiative; Turning Point: Collaborating for a New Century in Public Health. See the website at www.rwjf.org.







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