Meeting Minutes
Participants : Ron Chen, Shingfen Wang,
Linda Peng RDA, Ching-Shin Wong, Yuaner Wu, Leslie Tang.
Location: Conference Call
Time: January 14, 2010. 9:00-10:10 pm.
Tasks
• Service location- San Jose
-2355 Oakland Road, San Jose, CA 95131
• Near-by dentist office or clinics data---Ron Chen, confirmed.
- Five or ten miles radius area dental clinics research.
-There are 200 dental clinics within 5 miles range, and 60 within 3.
-Yahoo link:
http://local.yahoo.com/results;_ylt=AgPccQdsJUyLQ0xQTrBOHy6HNcIF;_ylv=3?p=DDS&radius=3&sortby=adistance&csz=2355+Oakland+Rd,+San+Jose,+CA+95131&flnstr=-1&flsstr=8&ppg_nm=4&pg_nm=1&xargs=&start=7
• Demographical data ---Grace Jen, confirmed.
- San Jose has more Business than residents.
- Current county censor is dated 10 years ago.
• County PHD---Grace Jen, confirmed.
- Most of the required inspection and documents for Business License application are near completion. The license is expected to be issued in the near future.
-
• Qualification---Yuaner Wu, confirmed.
1. Referral by Social Worker.
2. Referral by educational organization such as school programs.
3. Referral by Charity Organization such as Tzu Chi Charity Group.
4. Medicaid/Medical card for walk-in patients.
- Sister Yuaner suggested that Tzu Chi considers providing free dental services at areas with less dental service density such as Gilroy or South San Jose. Because:
- The public domain of dental services focus mainly on the north side of Santa Clara County.
- There are several private nonprofit organizations such as McDonald’s provides free dental services in Santa Clara County, again focus more on the north. Sister Yuaner and Dr. Wang will visit McDonald’s dental van for details.
- For over all public health consideration, Tzu Chi may need to partner with Santa Clare County Health Department Special Dental Treatment Program as mutual referral entity. Budget constrain is the reason County needs to refer patients to private sector. Each serves as screening party for patient medical need and financial situation and refers to another if needed. Documentation will be maintaining by both parties. Such service includes children and adults.
- Tzu Chi remains the right to refuse referral from the County bases on capacity limitation.
- Tzu Chi may serve as a Gateway for the County at remote south side and serve patients with Medical qualification.
- Tzu Chi may alternate north-south service days to start with.
- Tzu Chi may use a Community Center parking lot for fixed location dental service at South with the Center’s agreement.
- Tzu Chi will provide the County operation schedule and service scope for referral.
- Sister Yuaner will provide a written Patient Qualification proposal.
How Santa Clara County provide dental care---Yuaner Wu.
In summary:
1. Under Santa Clara County Public Health Department (SCDPHD), Community Outreach Services Unit is in charge ofperforming mobile dental services to cover the majority of San Jose Unified and Gilroy Unified school districts.
2. The Executive Director of the Santa Clara Valley Health& Hospital System will be delegated to execute the project.
3.There are threemobile dental vans ran by the SCDPHD to provide dental services tochildren, and adultwho has medicare, medical or low income.
4. Mobile dental vans are staffed by county employees, the dental director Dr. Kito overseesthe operation of all the mobile dental vans.His office is located at Valley Health Medical Center.
5. Mobile dental van are scheduled to station at fivecommunity health clinicsand homeless shelters routinely. Five health clinics includes valley health center at east valley, Gilroy, Fair Oaks, Sunnyvale and Tully.
• Define service scope and schedule---Singfen Wang DDS, Ching-shin Wong DDS
both confirmed.
Linda Peng RDA.
- Budget will be the major guideline.
- Service day may start with Sunday when most DDSs are off regular duty.
- May add one weekday which is scheduled after the survey of all DDSs’ schedule.
By Sister Jenny as followed:
Dr. Ching Hsin Wong.....Monday or Thursday (6x / year)
Dr. Stephanie Wang...... Sunday (once a month 12x)
...... Monday or Thursday (twice a month)
can be the backup when the date is low with DDS
Dr. Raymond Chu...... Sunday once a month (preferred Sunday)
...... Friday once a month
Dr. Jacqueline Lo...... One Sunday each month
Dr. Betty Wang...... Sunday (Once every other months 6x)
...... Friday (once every other months 6x)
Dr. Amy Huang...... Sunday (Once a quarater 4x)
...... Wednesday morning only (once every 2 months)
- Scheduling will be coordinated with current dental outreach program.
-
Service scope
For Outreach event and first year Fixed-location operation
· Screening / Triage,X-Rays
· Palliative Care
· Restorative---Amalgam, Composite, Pin Retention Capping,TemporaryFilling
· Crown / Bridge Recementation
· I&D Abscess,Fistula/Apical Curettage,Non-complicated Extraction, Non-surgical Roots Remove
· Gross Scaling,Root Planning, Oral Hygiene Instructions
· Fissure Sealant,Prophylaxis,Topical Fluoride
Re-assessment after one-year operation at fixed-location
Beside the above services, may suggest including:
· Therapeutic Pulpotomy—Deciduous molar
· Root Canal Tx-single canal
· Stainless Steel Crown--- Deciduous molar
· Provisional Crown--- chair side
· Denture Repair /Reline----chair side
Stay Plate / Flipper, Full/ Immediate Denture--- Lab
Emergency Backup Plan and In-need Referral
Paramedic / Local Hospital ER
· Anaphylaxis- after on-site initial intervention
· Uncontrolled bleeding
· Other medical emergency encounters--- ex: cardiovascular….
Community Dental Clinic
o during our non-operation day
§ Spomstenus pain—related to pulpitis, pericoronitis, AUNG, dentoalveolar abscess….
§ Broken filling, fractured/cracked tooth, crown/filling fell out
§ Swelling, fever
§ Hypersensitive reaction to prescribed medication
§
o During our operation day
§ Root canal Tx
§ Surgical extraction
§ Prosthetics/prosthodontics
Estimate Lab fee ( asNiko Dental Lab)
-Full denture flat rate $165
-Stay plate with first tooth $85, each additional tooth/clasp $5
plus tax
Would we consider to have patient pay the lab fee only for themselves if they want to have denture done by us?
(private clinic UCR for full denture is ~$ 1,000 to $1.400)
Base on the principles of cost-effectiveness in making decisions about the utilization of limited resources and altruism,I think certainprocedures, like denture, single root canal tx, are quitebeneficial for patient because they are much costlier at private clinic and these procedures can actuallysimply improve their appearance or save a savable front tooth without that high overhead. (andclinicallyless risk )
Principle and Direction of Service scope to follow:
Tzu Chi will provide basic free dental services as currently provided at outreach program for the first year. An evaluation will be conducted after that, and decision of expending service scope will be made.
• Operation resource---Jack Yeh, Chijen Huang, confirmed
- Service day
- misc support - 委員, 午餐, 慈濟人文等.
- Facility planning-portable, mobile
- Non-service day
- Administration – patient reservation, case, and referral.
- Patient reservation may be done by special group of volunteers at SJ
office.
-SJ office may set up an extension line for dental reservation purpose or others—TBD
- Follow-up and general inquiry
- Follow Tzu Chi four in one structure for volunteer scheduling support.
• Internal training---Jack Yeh, confirmed.
- service or non-service related volunteers.
• Professional training---Linda Peng RDA. Confirmed
- DDS needs professional assistance from DA. Currently, the experienced DAs
are difficult to schedule, while less experienced DAs need chance to practice.
- Possibility of DDS take in interns at their private clinic.
- A 50% time paid DA may be needed to be in charge of office operation.
Staffing, dentist, DA, charting, material inventory, equipment maintenance,
office upkeep, etc. Details of duty consult Amy and Ling Phie.
- Sister Linda will write up a part time DA job description based on existing DA
job description provided by Brother Chijen.
- The potential paid DA may be hired among current Tzu Chi DAs.
- Recruiting will be conducted a year after the start of operation. Temporary office support will be provided for the first year.
• Regulatory requirement---Yuaner Wu, confirmed.
- Consultant Tom Terry is current Tzu Chi regulatory advisor, who advises in
writing of Compliance Manual. He has one year contract with Tzu Chi. Need to
inform him of San Jose new location, therefore possible new regulations.
• Budgeting---Chijen Huang. Pai Ta Chu, confirmed
- Consult LA model.
- Yuaner will be the contact with LA.
- An initial budget will be decided with further revision.
- Material, equipment, personnel.
• Referral and community connection---Chung-Yuen Hwang, confirmed
- Hospital/Medical Center Affiliation. A list of such centers is attached.
- What can these centers accommodate our referral? Service scope needs to be
established.
- DDS decision based on good will.
-LA model which excludes elective procedure.
-Medical emergency referral.
-After hour referral.
-Out of Tzu Chi service scope referral-elected by patients.
- California Healthy Family can be one of the referral centers but covers
children and young adult only.
- Establish MOU with such centers.
- Contact with local dental clinic.
• Patient confidentiality –Weiwen Lin
- X-ray images and patient information stored in a portable device (notebook)
can be taken easily. Shared files over network needs security guard.
- Assign patient number for security purpose.
- Charting Software and X-Ray software ---- Weiwen Lin
- Paper documentation will be kept before establishment of the software
Summary from Nov. monthly call with LAMedical Foundation
· Clinics license :
- Satellite clinics (both Fresno and SJ) : based on Milpitas office address,
but can change to SJ new facility by amendment after granted
- License should be in place 2-3 weeks after PHD visiting Medical -
Foundation on 11/16; afterwards, we can start business license
application locally
· Fixed-location Dental program :
- fixed-location dental service is covered by the license
- sister Debra suggests to render service using mobile van ONLY
- office space can still be used for registration, waiting areaand charting
- budget, service scope and frequency is still under evaluation
Action items:
1. A special meeting will be called to discuss Dental prevention aspect in areas of Patient Qualification and Service Scope.
- Information on fee structure of community low cost clinics by Brother C.Y
- Consult LA Medical Clinic regarding office management by Brother Jack.
Brother Jack will write up a draft on current LA medical office personnel structure after confirmation with sister HweiTing.
- Explore Charting Software and X-Ray software by Brother Weiwen.