Oral/Dental Health Projects

The HRSA/HCFA Oral Health Initiative (OHI) is one of several national efforts to place attention on the need for improved oral health care. The Initiative is a collaborative effort of the Health Resources and Services Administration (HRSA) and the Health Care Financing Administration (HCFA). The Oral Health Initiative seeks to strengthen public and private oral health delivery systems, enhance collaboration among government agencies and programs responsible for financing children's oral health and encourage the application of scientific advances to the practice of dentistry to reduce disease burden. The Initiative was boosted into more limelight in 2000 when the Surgeon General's Report on Oral Health in America, was released in early 2000.

I have had the opportunity to translate our state-community policy change strategy to our work with the HRSA/HCFA Oral Health Initiative. Together, we have developed a state oral health strategy whose purpose is to change both state and local policies and practices to improve oral health status. The components of the policy change strategy and our typical role in each are described below:

Policy briefing and orientation with/from federal and state HRSA and HCFA staff. Prior to the implementation of an oral health strategy, a briefing between myself, state oral health program staff, and key federal policymakers at the regional and national level is held via conference call. I provide the agenda and facilitation for this call.

Purpose statement, desired outcomes and strategy components for the state oral health strategy discussed and decided. A planning committee or team of key stakeholders within a state -- including state dental directors, state oral health program staff, state dental professional groups, Head Start, primary care associations and others -- is the focal point for this component. Once a planning committee is assembled, I work with the group to develop a purpose statement for an oral health strategy, as well as what strategy components need to be put in place to meet that purpose. Components might include the following:

State Oral Health Summit. A state wide oral health summit meeting is currently the most prominent aspect of some states oral health improvement strategy. Organizing, preparing for and conducting an oral health summit requires the following:


• Developing a defined purpose for the meeting.
• Developing a Summit agenda based on the context and desired outcomes for the Summit as a component of an overall state strategy.
• Preparing for the meeting, which includes soliciting information from persons invited to the Summit, securing media interest, and adjusting the agenda as necessary. Preparation also requires at least monthly conversations with the state planning committee to discuss progress and meeting developments. During these conversations, I help to negotiate and broker ideas for the summit and its follow up between Planning Committee members.
• Facilitation of the Summit meeting, which includes large group facilitation, as well as specific small group facilitation whose purpose is to identify potential strategies for implementation.
• Developing meeting proceedings and providing guidance their dissemination. The Planning Committee and I work together to communicate the most important aspects of the meeting through the Summit proceedings, and to share the proceedings with key stakeholders across the state as well as meeting attendees. Websites are becoming a popular method to post the meeting proceedings as well as follow up strategies from state oral health summits. For examples of proceedings that have been produced from summits I have facilitated, visit the following sites: Montana; North Dakota; and Maryland.
  

State Oral Health Coalition building for oral health improvement. Some states have organized Coalitions for oral health improvement; others build Coalitions as the result of a state meeting such as a summit. Typically the Planning Committee for a summit becomes the guiding members of a new coalition. Strategies that result from a summit provide the rationale for organizing work groups of a Coalition. Both the Planning Committee as well as Coalition work groups require assistance in setting direction, outcomes for short and long term work and a process for meeting those outcomes. A one day meeting with key stakeholders in follow up to a summit, or other state wide event (such as community meetings -- see below), provides the assistance needed by state Coalitions to address oral health issues. I have worked with Planning Committees to organize and facilitate follow-up meetings with key stakeholders, as well as community wide efforts.

Community meetings to gather information, advice and/or support (5-7 across the state) in follow up to or in preparation for a state oral health summit. This component consists of multiple meetings around a state to gather input on the current scope of oral health/access to dental care challenges, as well as to gather feedback on either the strategies proposed by a Coalition or other state group to improve oral health. This component can be implemented prior to, or in follow up to a Summit, or as part of an activity sponsored by a state oral health coalition. I have worked with Planning Committees and Coalitions to organize, facilitate and capture the information from community meetings, and then to apply the information to organize a state summit or a Coalition's next steps.

Legislative briefings and legislation development. Policy change to improve oral health or access to dental services often requires legislative change. Educating policy makers about the necessity and importance of oral health requires careful planning. Additionally, many members of state Coalitions may not have experience in drafting or presenting legislation. Stakeholders often require technical assistance to appropriately plan for special legislative sessions, draft legislation, and secure support for legislation that helps to improve access to dental services and oral health. I would work with a Coalition or Planning Committee to develop materials, organize a legislative briefing and subsequently help the Planning Committee to draft legislation in conjunction with the appropriate legislative staff in a state. The Montana Dental Action Plan, produced in September 2000 is an example of the outcomes from a legislation development meeting. The Missouri Coalition for Oral Health Access is hosting a meeting in February 2001 for legislators and policy makers, as well as Coalition members. This session will provide an opportunity to speak directly with legislators who have drafted legislation, and for the Coalition to indicate their support for upcoming bills and appropriations.

I developed a policy brief in February 2001 that describes the short term outcomes from several state dental summits as a component of the strategy. Click here to access that report in adobe acrobat format.

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