December 5, 2016
Meeting Notes
Florida Oral Health Alliance Result: All Florida children, youth and families have good oral health and well-being, especially those that are vulnerable.
Headline Indicator 1: Percentage of eligible Medicaid children ages 0-20 receiving any dental services
Headline Indicator 2: Percentage of eligible Medicaid children ages 1-20 receiving any preventive dental service
Meeting Results:
During the meeting, participants:
• Addressed challenges in aligning actions around the Oral Health Alliance results
• Shared updates on performance measures for tracking success of subcommittee activities
• Updated one another on the communications action commitments to share the FOHA plan with other state and local partners
• Shared understanding of ways to engage partners and community residents in implementation
• Discussed how to align the Florida Oral Health Alliance work with other oral health groups statewide
Meeting participants / OrganizationSocrates Aguayo / AmeriGroup
Betty Gilbert / LIBERTY Dental Plan
Douglas Manning / DentaQuest
Alina Soto / Florida Department of Children & Families
Megan Weiland / AHCA
Project Staff
Deitre Epps / Clear Impact
Danielle Lewald / FIHI
Moving from Talk to Action: Update on Action Committments Since 10/28 Meeting
1. Share data on number of children receiving preventive dental services
· Will need to revisit the following action committments during Jan. 13 meeting:
i. Dr. Bilger: Will gather state-wide data
ii. Scott Staten: Will send data from Palm Beach County
iii. Alina Soto: Will gather HeadStart data (children ages 2-5)
iv. Marguerite Lynch: Will share data on the % of 6-9 year olds that receive sealants
v. Tamara Kay Tibby: Will share the DentaQuest Provider Performance Report which includes data on sealants: total ages 6-9 in sealant programs, comparing performance with other providers
2. Conduct outreach in the next 4-6 weeks to selected partners by sharing the FOHA plan and determining how their work aligns with the prioritized factors and strategy implementation
· Link to the Florida Oral Health Alliance Plan provided to facilitate member outreach to potential partners:
http://flhealthinnovation.org/wp-content/uploads/2015/04/FL_OH_AL-Strategic-Plan_Final-1.pdf
· Will revisit progress during Jan. 13 meeting:
FOHA Member / Selected Partner / Action CommitmentMarguerite Lynch / Ben Browning, Florida Association of Community Health Centers / Outreach to discuss FOHA plan and how he can support implementation
Scott Staten / Cathy Burns, Health Liaison for Palm Beach County School Board / Outreach to discuss FOHA plan and how she can support implementation
*Scott to send FIHI Cathy’s contact info to be added to partner list
Philippe Bilger / Dr. Zapert, FDOH, state-wide dental director / Telephone call and discuss strategic plan and next steps (will get next steps from him)
Alina Soto / Brittany Birken, FL Children’s Services Council / Discuss data and best practices for funding decisions on oral health (she’s very active with legislature)
Doug Manning / Managed Care Plan contacts / Will distribute the plan and have regular weekly/monthly meetings with teams to discuss the plan and see where/how they can get involved or if they can commit
Casey Stoutamire / External: Members of the Florida Dental Association
Internal: Board of Trustees, Action committee, and communications team / FDA members are dentists; will use parts of the plan to advocate for sharing messaging and education around oral health
Summary of Action Committments from 12/1 Meeting
FIHI:
· Update FOHA Strategic Plan executive summary and PPT template
· Facilitate collaboration with partner organizations in other counties to establish virtual meeting hubs (i.e. United Way of North Central FL)
· Invite representatives from other FL oral health coalitions and groups to provide updates on state oral health landscape at upcoming meetings in 2017 (i.e. FL Oral Health Coalition, AHCA, FDOH)
FOHA Members:
· Doug Manning and Socrates Aguayo to share best practices and preliminary progress around school-based sealant intervention in early spring 2017.
· Alina Soto to speak with Carrie Hepburn (Tampa Bay Healthcare Collaborative) at Catalyst Miami meeting to gather update on State Oral Health Alignment meeting in Orlando.
Partner Alignment with the Alliance
Do you know of any other groups that are aligning around specific measures within the FOHA strategic plan?
· Not aware of other groups targeting specific measures. AHCA was looking at increasing preventive dental services because that was a federal guideline (MMA contracts), not aware of current status.
What exists in the state of Florida that is already addressing one or more of these factors that you could align with?
1. Prioritized Factor #5: There is a lack of consistent collaboration from partners and stakeholders, including oral health understanding by legislators.
2. Prioritized Factor #7: There is a lack of real time data that can identify which patients need dental care. Data is needed at the patient level.
· Oral Health Florida (state coalition, similar to Alliance), has different sub-groups around data and ED utilization, medical/dental, senior oral health, and sealants. Last meeting was March 2016. They are currently going through a re-vamp. Some priorities fit in with our prioritized factors.
· AHCA’s Medical Care Advisory Committee (MCAC), looks at how services are being utilized and accessed.
· Challenge is that data has been inconsistent; it has been in a bunch of different buckets but no one has been able to put it together. Prioritized factor #7 within the FOHA plan has tried to address this in addition to getting real-time data that health plans and dental plans could use to get patients the best care.
How do we move past the planning stage to implementation? Does it mean bringing in other groups?
· Aligning with statewide groups is a different strategy than regional groups (Tampa Bay). Feel there is a lack of knowledge/capacity to bridge that gap.
Is there a willingness to work with other partners? How do we address barriers to collaboration?
· Connect with the Tampa Bay Healthcare Collaborative on State Oral Health Alignment Meeting (Alina Soto to speak with Carrie at Catalyst Miami meeting).
· Having a co-meeting to see how we can work together to align. Opportunity to partner with Oral Health Florida Coalition who hosts quarterly leadership council calls, ongoing sub-committee meetings and a larger annual meeting in June (Doug Manning and Alina Soto are involved).
Aligning Actions with Oral Health Alliance Results
1. Pg. 23 Strategy #7: Expand school-based oral health programs through sharing best practices already in place. (Focus Area - Barriers to Oral Health Care)
Performance measures:
· # of students who receive preventive oral health services
· # of children who receive preventive oral health services
· All partners can begin collecting this performance measure data and share with one another when you come together so you can begin understanding the impact of oral health services on children and students.
What works?
· DentaQuest is working with Amerigroup, Anthem and DOH to partner on dental sealant consent form process to increase utilization of school-based sealant programs. AmeriGroup is looking at schedules to find out when schools are planning to provide sealant programs and providing follow-up to parents in that area to ensure they turn in consent form.
o Focus counties: Pasco, Polk, Osceola (FQHC), soon in Miami-Dade
o From data perspective, we can look at which regions have low consent form returns and assess if incentive programs are working. DentaQuest is working with all health plans to expand school-based dental sealant programs and ensure they’re submitting claims properly and correctly.
· Kim Herremans with the Greater Tampa Bay Oral Health Coalition (GTBOHC): Runs a successful program related to dental sealants in Hillsborough County with consent form return rates of 80% using incentive strategies.
o How do you come up with strategy/funding for this? If we find out that pizza parties are working, how do we expand and do this on a larger scale? How can we expand this beyond the 4 counties?
§ This broader effort has increased energy and focus around dental sealants. It offers a higher opportunity of revenue because it allows groups to expand their services. Dental plans are open to consultation on how to approach this.
§ Doug Manning and Socrates Aguayo to share best practices and preliminary progress around school-based sealant intervention in early spring 2017.
· Best practices:
o Apple Tree Dental in Minnesota expanding services in rural areas to bring services to the patient.
o Healthy Schools LLC (in Palm Beach), wide-reaching and have been successful in expanding services to areas that don’t have access.
Story Behind the Curve
· In 2001 there was a lot of fraud, waste and abuse around mobile dental vans. Private operators were giving incentives to kids (gift cards), and defrauding Medicaid. AHCA came down hard on mobile dental units and restricted them to FQHCs, dental schools, and CHDs (County Health Departments).
o A declaratory judgement has been submitted to AHCA to define what is a mobile dental unit. The state has to make a determination if portable dental equipment is restricted or not. If it’s decided that portable equipment is not a mobile dental unit, there could be a large expansion of these programs. Decision should be reached in the next 30 days.
· Dental hygienists can now do screening, fluoride and cleanings in health access settings without a dentist being present or doing a prior exam. Health access legislation has opened the door for expanding and utilizing dental hygienists in this role. CHDs, FQHCs are jumping on this. Nursing homes are currently doing this.
What do we propose to do?
What do you think about this as an activity and what role might FOHA move this forward?
· Advocacy, education (write to legislators) that mobile dental equipment is not portable equipment to influence AHCA decision.
How can we engage other counties in our work and bring additional groups together virtually?
· Meet with state-wide Oral Health Coalition and align with the work of their dental sealant sub-committee.
· FIHI to facilitate partnership with United Way of North Central FL in Gainesville who expressed interest in connecting with this work.
· Invite different groups to present at an upcoming meeting to provide updates on the Oral Health landscape in the state:
o Florida Oral Health Coalition: Align with dental sealant subcommittee work
o AHCA Medical Care Advisory Committee (MCAC): Where is MMA heading? Update on Telehealth advisory committee work (Erica Floyd Thomas-AHCA contact)
o What is FDOH doing to expand school based sealant programs?
Communications and Messaging Strategy
Feedback on FOHA Communications PPT Template:
· Reduce text/minimize content
· Discuss adoption during Jan. 13 meeting
Feedback on FOHA Executive Summary:
· Simplify language to a 3rd grade level and define unknown terms
· Update design/color scheme to match PPT
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