Request for Proposals Oregon Children’s Dental Health Initiative



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Request for Proposals

Oregon Children’s Dental Health Initiative

Improving access to prevention and education services throughout Oregon

Letter of intent encouraged by September 1, 2014
Due date for applications: October 15, 2014
Funding decision: February 2015

A funding opportunity made possible by The Oregon Community Foundation,
Northwest Health Foundation, Kaiser Permanente, Providence Health & Services, and other partners

Overview


Too many children in Oregon are living with untreated tooth decay, a preventable problem that can be addressed effectively in a school setting. Additionally, certain regions and communities are disproportionately affected by poor dental health. In 2012, children ages 6 to 9 in southeastern Oregon had cavity rates that were 20 percent higher than those of children in the rest of the state. And Latino children in Oregon are twice as likely as white children to have rampant decay, which is defined as decay in seven or more teeth (Oregon Smile Survey, 2012).

Although many effective school-based programs exist, they need assistance to expand and sustain their efforts to reach eligible students. To serve more Oregon children and support the sustainable development of children’s dental health programs across the state, The Oregon Community Foundation (OCF), Northwest Health Foundation (NWHF), Kaiser Permanente, Providence Health & Services, and other funding partners announce two funding opportunities as part of a statewide Children’s Dental Health Initiative.

The first funding opportunity is for communities to start a comprehensive children’s dental health program offering school-based services, with an emphasis on reaching communities most impacted by poor dental outcomes.

The second funding opportunity is for existing children’s dental health programs that currently provide school-based services to expand and develop a sustainable comprehensive model.

Innovative, community-driven approaches are encouraged. Through this Initiative, the funders aim to increase access to oral hygiene education and supplies; prevention services (including risk assessments, screenings, sealants and fluoride varnish applications); and necessary treatment services through effective case management.

In addition, the funders aim to strengthen programs by supporting their capacity to develop partnerships and contracts with local Coordinated Care Organizations and/or Dental Care Organizations to provide school-based prevention services to students on the Oregon Health Plan, with funding from Medicaid.


Definition: A Comprehensive School-Based Children’s Dental Health Program


A comprehensive school-based children’s dental health program provides annual screenings, sealants, fluoride varnish applications, dental supply kits and oral hygiene education to students at elementary and middle schools. Program staff and volunteers work cooperatively with school personnel to get the maximum number of students to participate in the program. When students are identified as needing treatment by a dentist, program staff and volunteers work with the parents or guardians, school personnel and a local dentist to get the child into the dentist’s office.

A comprehensive program provides the wraparound services needed to prevent dental disease and to get children with dental disease the treatment they need before it worsens. A comprehensive program also relies on broad community engagement and partnerships between schools, dental professionals, Dental Care Organizations, healthcare providers, public health officials, community volunteers and others to coordinate education, prevention and treatment services. Please see the Appendix for a case study of one comprehensive program, Ready to Smile, which serves as a model for this Initiative.


Eligibility


Nonprofit organizations or public entities may apply for either funding opportunity, but not for both. The first funding opportunity is for starting a comprehensive school-based children’s dental health program. Eligible organizations are those that want to start a brand-new program, or have started a program in the last two years that is not yet comprehensive as defined above.

The second funding opportunity is for existing school-based programs that have a strong track record of providing comprehensive dental health services over the past three years, but need support to expand their services and become sustainable.


Process Overview and Funding Information

First Funding Opportunity: Starting a Program


A letter of intent to apply is encouraged, but not required, by September 1, 2014.

An application is due on October 15, 2014. This application is for a nine-month Planning Grant to develop the comprehensive program. Funds will be awarded in February 2015.

An application for four years of funding to implement the comprehensive program is due on October 15, 2015. Funds for the first year of implementation will be awarded in February 2016. Additional years of funding will be awarded annually, contingent on the grantee meeting the expectations of the grant.

Applicants may apply for up to $30,000 for the Planning Grant and up to $70,000 for each of the first three years of implementation funding. The request for the fourth year of implementation funding may not exceed $60,000 and will require the organization to raise $10,000 to support its program during that fourth year. Selected applicants will receive up to $300,000 over five years through this funding opportunity.

Additional funding for technical assistance and to attend Grantee Gatherings will be provided.

Second Funding Opportunity: Expanding and Sustaining a Program


A letter of intent to apply is encouraged, but not required, by September 1, 2014.

An application is due on October 15, 2014. This application is for three years of funding to expand and work on developing a sustainable comprehensive program. Funds will be awarded in February 2015 for the first year of funding. Additional years of funding will be awarded annually, contingent on the grantee meeting the expectations of the grant.

Applicants may apply for up to $50,000 per year for three years. Selected applicants will receive up to $150,000 over three years through this funding opportunity.

Additional funding for technical assistance and to attend Grantee Gatherings will be provided.


Competitive Process


To date, approximately $2 million has been committed for these funding opportunities. The funders for this Initiative are actively raising money to support as many new and existing programs as possible throughout Oregon. The number of grants awarded will depend on the number and type of applications submitted and the funds raised. Priority will be given to applicants that demonstrate a commitment to providing services to schools with 50 percent or more students on Free and Reduced Lunch and students from communities of color.

Expectations for First Funding Opportunity: Starting a Program

First Step: Apply for a Planning Grant (due October 15, 2014)


Some Oregon communities offer very few school-based dental education and prevention services. Schools may have sporadic visits from a mobile dental van, or receive services from the Oregon Health Authority’s School Sealant Program, but a comprehensive dental health promotion program that includes oral hygiene education and supplies, sealants, fluoride varnish applications, and treatment referrals for children in grades 1, 2, 6 and 7 does not exist. (Special emphasis is given to these grade levels because first and second molars typically erupt at these ages.)

For communities interested in starting a coordinated, comprehensive program, a nine-month Planning Grant is available. The purpose of this grant is to provide the time to convene the appropriate stakeholders (such as dentists, insurance representatives, school nurses, government, parents, and leaders in education, healthcare, business and public health); develop plans for a school-based program; and get letters of commitment from various partners needed to implement the program.

Competitive applications will describe why the community needs to start a program or to continue building one that is less than three years old. The application should explain why the applicant (nonprofit organization or public entity) is well positioned to lead the coordination effort for the Planning Grant, and it should also identify partners who have indicated an interest in working on this program.

Eligible Activities for Planning Grants

Planning Grant funds may be used for:

Staffing

Convening meetings and providing meals at meetings

Conducting an inventory of existing dental services provided to schools (Needs Assessment)

Travel for meetings

Materials and supplies

Developing the plan

Writing the grant application for the four years of program implementation funds (due October 15, 2015)

Strong proposals will:

Describe who is involved with the planning process — meaning the actual people involved — and why they are committed to developing a comprehensive dental health promotion program for elementary and middle school students. The proposal should also identify a lead coordinator (staff member or volunteer) who is helping to secure the Planning Grant.

Describe the region that the program will serve (towns, cities, counties, likely school districts).

Demonstrate a clear understanding of the need for a comprehensive dental health promotion program in the region by describing what currently exists and what could be done to improve access.

If applicable, describe partnerships in place with organizations and volunteers who are committed to developing this program.

Demonstrate a commitment to serving schools with 50 percent or more of students on Free and Reduced Lunch and students from communities of color.

Demonstrate a track record of running a program and delivering services to students from low-income communities and from communities of color.

Demonstrate an understanding of which services should be provided and how.

Describe how the planning team will engage the local Coordinated Care Organization and/or Dental Care Organization in the process.



Outcomes for Planning Grant
For those applying for a Planning Grant to start a new program, or to make a program that is less than three years old comprehensive, the following outcomes are desired by the end of the nine months to demonstrate a community’s readiness:

A steering committee is established


A strong, dedicated and diverse group of individuals representing education, dentistry, public health, healthcare, insurance, government and other fields is responsible for overseeing the planning and development of the new comprehensive dental program.

A lead organization is identified


One organization is responsible for applying for the funding to implement the program; managing the grant; hiring and supervising the Program Coordinator; tracking expenses; and submitting grant reports to OCF.

School principals are committed to participation


All participating school principals submit letters demonstrating their commitment to participation in the program and their understanding of what is required from their personnel and what will be provided to students.

A Dental Care Organization is a partner


At least one Dental Care Organization or Coordinated Care Organization is a partner and commits to providing school-based dental prevention services.

Applicants will be expected to demonstrate these outcomes in their application for funding to implement the program over the next four years.

Grant Requirements


By October 15, 2015, the Planning Grant grantee will need to complete and submit a plan for implementing a comprehensive program. The plan and associated budget will serve as an application for four years of funding to implement the program. Well-defined plans will be required for implementation funding. Successful grantees will be expected to participate in, and to provide information for, the Initiative Evaluation. Compliance with the grant requirements will be an eligibility condition for funding to implement the program.

Deadlines


Please submit a letter of intent by September 1, 2014, if you plan to apply for a Planning Grant. This is not required, but strongly encouraged.

Planning Grant applications are due on October 15, 2014. Funding decisions will be made in early February 2015. Selected applicants who receive a Planning Grant will receive funds in February and will be invited to submit their application for launching and implementing their new programs on October 15, 2015.

Second Step: Apply for a Four-Year Grant to Implement a New Program After the Planning Grant (due October 15, 2015)


After the nine-month Planning Grant, organizations will be eligible to apply for four years of funding to implement the new comprehensive program. Competitive applications will demonstrate a plan to do the following:

Employ a Program Coordinator


The lead organization must hire a Program Coordinator who will launch and implement the program, coordinate staffing and school schedules, build and maintain relationships with school and dental personnel, collect and report data, participate in the evaluation of the Initiative, assist with fundraising to sustain the program, and perform related duties.

Provide coordinated dental education and prevention services in a school setting


Distribute permission slips through school registration packets to ensure the highest participation rates, and go to schools in advance of dental service days to get permission slips returned.

On dental service days, provide oral hygiene and nutrition education, oral screenings, fluoride varnish applications, sealants, dental supply kits, and (when needed) referrals for treatment.

Enroll eligible students in the Oregon Health Plan.

Work with parents, school personnel and a local dentist to get students with urgent treatment needs to the dentist’s office promptly.

Track services provided, and share the data with school principals within a month of the delivery of services.

Complete and submit progress reports every six months to OCF on March 1 and September 1.


Integrate with Coordinated Care Organizations and/or Dental Care Organizations


Sign an agreement /contract between the local Coordinated Care Organization and/or Dental Care Organization and the grantee to deliver services to children on the Oregon Health Plan and to receive Medicaid reimbursement from the global budget for these services.

Use volunteers


Recruit local dentists to partner with the program who agree to promptly serve students identified as having urgent needs (for example, one dentist may agree to serve students from one or two schools if they need urgent treatment; another dentist would serve two other schools in the area).

Recruit and train community volunteers to help with assembling dental kits, keeping children moving efficiently through the service stations on dental service days, providing oral hygiene and nutrition education, calling parents when urgent needs are identified, and other necessary tasks.


Meet with the Steering Committee


The Steering Committee should meet at least four times a year to receive updates on the program, and also to provide input, develop and implement fundraising plans, identify problems and work on solutions.

Eligible Activities for Implementation Grants of New Programs

Implementation Grant funds may be used for:

Staffing

Convening meetings and providing meals at meetings

Developing program materials (design, printing, copying)

Travel to schools and meetings

Purchasing equipment and supplies necessary for the program

Data collection, tracking, and evaluation participation

Small appreciation gifts for volunteers

Strong proposals will:

Identify the lead organization and describe plans for employing a Program Coordinator.

Describe how the dental hygienist and dental assistant will be employed to provide services at the schools.

Identify the schools that will be served; demonstrate a commitment to serving schools with 50 percent or more students on Free and Reduced Lunch and students from communities of color.

Provide letters of support from school administrators who plan to partner with the program.

Describe all services that will be provided to students.

Demonstrate a track record of running a program and delivering services to students from low-income communities and from communities of color.

Describe partnerships with organizations that are committed to implementing the program, and explain what they will contribute.

Describe a plan to integrate with the local Coordinated Care Organization and/or Dental Care Organization and to work together on improving children’s dental health outcomes.

Include plans for strengthening or developing a diverse Steering Committee to support the program’s integration with the local Coordinated Care Organization and/or Dental Care Organization and to strengthen the program’s fundraising capacity to become sustainable.

Describe a plan for informing and engaging community members as volunteers and advocates.

Describe the Steering Committee’s commitment to oversee the program and to raise funds.

Demonstrate a commitment to collecting and reporting data for the grant and participating in Initiative evaluation activities, such as interviews with the Initiative Evaluation Team at OCF.


Outcomes for New Program Implementation Grants


For grantees that receive funding to implement a new comprehensive program over four years after the Planning Grant, the following outcomes are desired by the end of each year. Selected applicants will be expected to demonstrate these outcomes in their progress reports to secure continued funding.

Student participation rates


The Program Coordinator made a significant effort to get permission slips returned in advance of dental service days, resulting in at least 50 percent of eligible students returning their permission slips.

The program served at least 40 percent of the eligible students who returned permission slips in grades 1, 2, 6 and 7 at each participating school.

The participation rate increases each year as people become more familiar with the program.

Dental services provided


The program staff provided oral hygiene and nutrition education, screenings, risk assessments and dental supply kits to all eligible participating students.

Sealants, fluoride varnish applications, referrals for treatment, and followup assistance (if urgent treatment needs were identified) were provided when the dental team determined students were in need.

The dental hygienist reported the student encounter data from each school to the partner Dental Care Organization or Coordinated Care Organization for all participating students on the Oregon Health Plan.

All services provided were recorded and tracked for grant reporting purposes.


Integration with Coordinated Care Organization(s) and/or Dental Care Organization(s)


Progress is being made to develop an agreement/contract between the local Coordinated Care Organization and/or Dental Care Organization and the grantee to deliver services to children on the Oregon Health Plan and to receive Medicaid reimbursement from the global budget for these services.

Fundraising


The Steering Committee conducted at least one fundraising event or gave presentations at local service clubs to raise awareness and funding to sustain the cost of the program coordinator each year.

The Steering Committee should also look to other partners to see who can cover ongoing program costs.


Volunteers engaged


At least five volunteers were recruited and trained, and served the program throughout the year. Each received a thank-you note or some other form of recognition.

Grant Requirements


Grantees will be expected to complete and submit progress reports every six months, provide information to the Initiative Evaluation Team at OCF throughout the Initiative, and send at least two representatives to grantee conferences in Spring 2015, 2017 and 2019 (expenses will be paid by funders of this Initiative). Clear instructions about data collection and reporting requirements for the grant will be provided at the grantee conferences. Compliance with the grant requirements will be an eligibility condition for grant renewals in subsequent years.

Deadlines


Implementation Grant applications are due on October 15, 2015. Funding decisions will be made in early February 2016. Progress reports will be due every six months, on September 1 and March 1, for the duration of the funding.

Expectations for Second Funding Opportunity:
Expanding and Sustaining a Comprehensive Program



Apply for a Three-Year Grant (due October 15, 2014)

Organizations that are currently providing comprehensive school-based dental services to underserved youth are encouraged to apply for three years of funding to expand services and to develop a sustainable funding model by partnering with local Coordinated Care Organization(s) and/or Dental Care Organization(s).

Competitive proposals will demonstrate experience providing dental services to underserved youth, a plan to expand these services, and a readiness to strengthen the program’s capacity to become sustainable with a diverse mix of revenue sources, including Medicaid.

Competitive proposals will also demonstrate support from the community. Proposals should describe the existence of, or the intent to develop, a local Steering Committee for the program; fundraising capacity and activities; and the number and type of volunteers who support the program.

Selected applicants will receive up to $50,000 per year for three years if project benchmarks are met. Additional funding will be available for technical assistance and to attend Grantee Gatherings.

Eligible Activities


Grant funds may be used for:

Staffing needed to expand services or assist with sustainability

Services provided to schools with 50 percent or more students eligible for Free and Reduced Lunch and students from communities of color

Equipment and supplies for the program

Travel to schools and meetings

Data collection, tracking and evaluation participation

Volunteer recruitment and training

Steering Committee meals and materials

Travel to develop partnerships with Coordinated Care Organizations and/or Dental Care Organizations

Minor fundraising expenses

Strong proposals will:

Demonstrate a track record of providing a comprehensive children’s dental health program, serving children from low-income communities and from communities of color in Oregon elementary and middle schools over the past three years. (Services may include, but are not limited to, recruitment for student participation; assistance to parents signing permission slips; providing screenings; oral hygiene education; placing sealants; providing fluoride varnish applications; providing referrals for treatment, and following up to ensure students received timely care; providing case management to ensure students receive proper care; and providing ongoing professional communication with schools and parents.)

Describe the partnerships that exist to keep the program running, including support from school superintendents, principals, teachers and school nurses; local dentists; community leaders; parents; and local government employees (county and state).

Describe a plan to become integrated with the local Coordinated Care Organization and/or Dental Care Organization and to work together to improve children’s dental health outcomes.

Include plans for strengthening or developing a diverse Steering Committee to support the program’s integration with the local Coordinated Care Organization and/or Dental Care Organization and to strengthen the program’s fundraising capacity to become sustainable.

Demonstrate a commitment to collecting and reporting data for the grant and participating in Initiative evaluation activities, such as interviews with the Initiative Evaluation Team at OCF.


Outcomes for Expanding and/or Sustaining a Program


The following outcomes are desired for this funding opportunity to expand or sustain an existing program. Selected applicants will be expected to track their progress as they work to achieve these outcomes:

More students served


More students received screenings, sealants, fluoride varnish applications, oral hygiene and nutrition education, dental supply kits, referrals for necessary treatment, and case management for urgent needs, because the program expanded into more schools.

More students were enrolled in the Oregon Health Plan.

More students were served because multilingual permission forms and multicultural approaches were used to engage parents and enroll students.

More students received treatment for urgent needs because a partnership was developed with a local Dental Care Organization or other dentists, enabling students to access their services.


Integration with Coordinated Care Organization(s) and/or Dental Care Organization(s)


An agreement/contract was developed and formally signed between the local Coordinated Care Organization and/or Dental Care Organization and the grantee to deliver services to children on the Oregon Health Plan and to receive Medicaid reimbursement from the global budget for these services.

More volunteers engaged


More volunteers were recruited and trained, and they served the program by helping program staff in the schools, serving on the Steering Committee, or providing dental care to students with urgent needs.

Grant Requirements


Grantees will be expected to complete and submit progress reports every six months, provide information to the Initiative Evaluation Team at OCF throughout the Initiative, and send at least two representatives to grantee conferences in Spring 2015 and 2017 (expenses will be paid by funders of this Initiative). Clear instructions about the data collection and reporting requirements for the grant will be provided at the grantee conferences. Compliance with the grant requirements will be an eligibility condition for grant renewals in subsequent years.

Deadlines


Please submit a letter of intent by September 1, 2014, if you plan to apply for this second funding opportunity. This is not required, but strongly encouraged.

Grant applications are due on October 15, 2014. Funding decisions will be made in early February 2015. Selected applicants will receive funds in February. Progress reports will be due every six months, on September 1 and March I, for the duration of the grant.

Application Procedures for Both Funding Opportunities
Application forms are available on the OCF website:
http://www.oregoncf.org/ocf-initiatives/children-and-families/childrens-dental-health

Step 1: Send a letter of intent by September 1, 2014 (There is not a specific form for this. Just type a letter and mail it to the contact below.)

Step 2: If you’re applying for a Planning Grant, complete and submit the Application Summary Form, as well as the Application Narrative Form for a Planning Grant.

If you’re applying for an Expansion Grant, complete and submit the Application Summary Form, as well as the Application Narrative Form for an Expansion Grant.

Electronic submissions are not accepted. Completed applications must be received by mail or in person at OCF’s Portland office by 5 p.m. on October 15, 2014. Applications postmarked October 15 will not be accepted.

Contact Information


Please submit letters of intent and applications to:

Melissa D. Freeman, Director of Strategic Projects

The Oregon Community Foundation

1221 SW Yamhill, Suite 100

Portland, OR 97205

For questions about these funding opportunities, please contact:

Molly Roman, Strategic Projects Coordinator

503.227.6846 or mroman@oregoncf.org

Appendix
Case Study: The Ready to Smile Program serves students throughout Coos and Curry counties


In 2010, The Oregon Community Foundation launched a comprehensive school-based children’s dental health program called Ready to Smile. The following information describes the process that South Coast volunteers used to start this program, as well as the components developed to provide dental education, prevention and treatment services to children in Coos and Curry counties.

First, OCF staff invited volunteers to participate on a Steering Committee to develop the program. Educators, school nurses, public health officials, dentists, hygienists, business leaders, and others convened to identify what services were currently available and what was needed to ensure students had access to basic dental disease education, prevention and treatment services. The Steering Committee quickly identified the need for all of the different services to be coordinated.

Next, the Steering Committee learned about other effective models in the state, such as the Salem-Keizer School District’s Dental Health Solutions Program, and identified the components that should be in place for a comprehensive program:

A paid program coordinator

A dynamic dental team, including a dental hygienist and a dental assistant who can provide school-based screenings, sealants and fluoride varnish applications to elementary and middle school students in grades 1, 2, 6 and 7, which are the ages at which first and second permanent molars erupt

Strong relationships with school administrators, school nurses and school secretaries

An administrative assistant to help with paperwork, data cleaning, and organizing materials

An age-appropriate oral hygiene and nutrition education component

Dental kits should be supplied to each student, and should include a high-quality toothbrush, fluoridated toothpaste, floss, brushing instructions and a two-minute brushing timer

Volunteers who can assist the Program Coordinator and Dental Team during school visits

Clearly written permission slips in multiple languages that are distributed to parents in the school registration packets

At least one or two dentists who can raise awareness about the program and encourage their peers to get involved, as in the following examples:


    • Some dentists have volunteered for the Ready to Smile program by opening their office on a Friday to serve students who have been identified as needing urgent treatment through school-based screenings. The program coordinator, school personnel and parents work together to get the students to the dentist’s office for the appointment.

    • Some dentists participate in the Neighborhood Dentist Program where they agree to partner with their neighborhood school and see students who need urgent treatment. When more dentists participate and each school has a dentist to call, the burden is shared by the dental professionals and they report satisfaction with the program.

A responsible organization that can administer the program, supervise the program coordinator, and report data and outcomes to the funders, among other tasks

A responsible organization that can oversee the dental team (this may be the same as the program administration organization)

A van to carry equipment and supplies to schools

Then, OCF partnered with Coos County Public Health to administer the program, providing the County with a grant to pay for staff, supplies, equipment and other expenses. The County hired a full-time program coordinator and began implementing the program in the majority of the elementary and middle schools in Coos and Curry counties in the fall of 2010.

In 2014, Ready to Smile continues to strengthen and evolve. Program staff have partnered with mobile dental vans, such as Medical Teams International and the Tooth Taxi, to assist in raising student participation rates when the vans visit a school. In addition, urgent treatment opportunities are available for students through Ready to Smile’s Neighborhood Dentist Program, which matches one volunteer dentist per school who is willing to provide care for students in need when identified by program staff. The Program Coordinator also helps children sign up for insurance through the Oregon Health Plan.

Ready to Smile is primarily funded by foundation grants and donations from individuals, local service clubs and businesses. However, a very helpful partnership also exists between Coos County and Advantage Dental, the local Dental Care Organization, to reduce staffing costs. Advantage Dental provides a dental hygienist at least two days per week to provide services at the schools. A partnership is also in place between Ready to Smile and the State School Dental Sealant Program that is offered through the Oregon Health Authority. This was developed in an effort to augment the services that the state provides to Coos County elementary school students. The state was unable to provide education or followup services when children needed treatment. Thus, Ready to Smile staff are filling in these gaps to ensure that all students in Coos County have the opportunity to receive comprehensive services.

The Steering Committee continues to meet and assists with raising awareness and funding for the program. School personnel have also embraced the program and assist staff in getting students to participate.



Ready to Smile staff collect data for every school they visit during the school year. This includes, but is not limited to:


Number of eligible students

Number of permission slips returned

Student participation rates

Number of students screened

Number of dental kits distributed

Number of sealants placed

Number of fluoride varnishes applied

Estimated dollar value of services if they had been provided in a dentist’s office

Number of presentations to raise program awareness and funding

Number of volunteers and hours provided



Developing and launching the Ready to Smile program was a labor of love by the South Coast volunteers and program staff. There were challenges all along the way, and the program continues to evolve as circumstances in the community change (e.g., staff transitions and changes in school personnel). But overall, the process for starting the program and the work being done to sustain it exemplifies what a group of concerned and committed Oregonians can do to improve lives in their communities.



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