HNH Foundation's Funding Helps Expand Oral Health for Young Children Up to Age 5
(Photo: Mary Parker, Dental Hygienist, examines a young patient at "Tooth Tuesday," Concord WIC Clinic. Photo Courtesy of Oral Health Program, NH Division of Public Health Services)
During 2013-14, funding awards from the HNH Foundation were made to accelerate oral health services for New Hampshire's vulnerable children and families. Specifically, HNH Foundation grant writing technical assistance resulted in a multi-year $1.2 million dollar award to further develop the New Hampshire Oral Health Program. In addition, a pilot project, with co-funding from the Jessie B. Cox Charitable Trust Fund of the Boston Foundation, was launched to inform the effectiveness of providing oral health prevention services to WIC-eligible children and women. Nancy Martin, Oral Health Program Manager at the NH Division of Public Health Services, calls 2014 the "busiest year yet." Her goals of improving the program's capacity to provide oral health services to underserved populations and continuous quality improvement are being achieved in a variety of ways.
Among the Oral Health Program's current initiatives:
- The second Healthy Smiles/Healthy Growth Survey, funded by the HNH Foundation, assesses changes in the oral health and height/weight status of New Hampshire third graders since the first survey was conducted in 2009
- The update of the New Hampshire Oral Health Plan (OHP) funded by the HNH Foundation, Northeast Delta Dental Foundation, and the Endowment for Health. This planning process, to begin in early fall, will build on the progress being made in oral health in New Hampshire, utilize current and emerging data, identify challenges and opportunities, set concrete goals and quantify resources needed to move forward
- The WIC/Pay for Prevention pilot project, made possible with funding from the HNH Foundation and the Jessie B. Cox Charitable Trust Fund of the Boston Foundation, reaches young children up to age 5 and pregnant women in Concord, Keene and Pittsfield
The WIC Pilot Project is increasing access to dental care
WIC (Women, Infants, and Children) is a federal program that provides a combination of nutrition education, supplemental foods, breastfeeding support, and referrals for health care to low-income pregnant, postpartum and breastfeeding women, infants and children up to age 5.
According to New Hampshire Oral Health Program Manager Nancy Martin, the WIC pilot program "is enabling us to reach out to women and children at-risk for dental disease by taking dental services to where we find the people. Thanks to the HNH Foundation, we have an opportunity to determine whether this effort is cost effective and if the pilot framework can inform a statewide sustainable preventive oral health system. We recognize that grant funding is often temporary, so the question becomes: How do we create a preventive oral health care system that is sustainable over the long run and is not dependent on grant money?"
The news so far is good
A team consisting of a dental hygienist (under public health supervision) and a dental assistant are providing comprehensive preventive oral health services and referrals to local dental offices on a regular schedule at WIC clinics in Concord, Pittsfield, and Keene. These pilot sites were chosen based on the size of the community, the high level of need, and the existing referral network - dental professionals willing to see patients up to age 5 and pregnant women. At the first dental clinic in Pittsfield, for example, two of the four pregnant women seen had urgent dental needs that required referrals for further treatment.
When asked about the results of the pilot so far, Nancy reported, "Our WIC pilot project is on the right track. Early oral health intervention for pregnant women and young children avoids more costly, involved treatment later on. We see the potential in WIC clinics that could be a model to move the whole system forward."
Nancy is being assisted by Stephanie Kelly who says that she wanted the kind of "on the ground" experience that the WIC Pay for Prevention pilot project provides: "Oral health is such an interesting field because it is easily ignored. People often don't appreciate the connection with overall health. I'm proud to be an oral health champion."
Stephanie's work includes the collection and analysis of data under the supervision of Dr. Lida Anderson, Chronic Disease Epidemiologist at NH DHHS, who is training Stephanie to interpret data being collected on i-Pads at the WIC clinics: "We are gathering solid data that will show the value of this work and the positive outcomes for moms and very young children. We'll be able to go beyond anecdotal evidence, and provide a data-driven economic analysis about the cost savings of early oral health intervention."
What would success look like for the WIC/Pay for Prevention project?
- a sustainable model of preventive oral health care for low-income women and children
- an improvement in overall oral health of pregnant women and children
- less untreated decay
- more dental sealants in place
- an increase in awareness among WIC clients about the importance of oral health - along with quantifiable proof of the economic benefit/cost savings of early intervention
One Family's Story
"My daughter is 3½ and I am expecting another girl in October. I was thrilled to be offered dental services at the WIC Clinic in Pittsfield. I haven't seen a dentist in years and it was my daughter's first dental procedure. They were awesome with her - a big ball of sunshine. They talked to her throughout the entire procedure, showed her how to brush, applied fluoride varnish, and said she had a perfect mouth. I also had my teeth cleaned, and now I've been referred for more work. I have been in so much pain because of dental problems - I haven't been eating solid foods for several months. Now I have appointments with a dentist and an oral surgeon to pull my wisdom teeth and get these issues taken care of. Everyone is treating me like a queen. I see a real need for this program - my sister is in the same boat as I am, and everything I've experienced so far has been wicked helpful. I am extremely grateful for this program - for me and for my children. Thank you!"
- Susan, Pittsfield, NH
2013 Annual Report reflects on Sandi Van Scoyoc's legacy
The HNH Foundation's 2013 Annual Report, published April 8, 2014, reflects on Sandi Van Scoyoc's 15years as President of the Foundation. In her farewell message, Sandi offers her "wish list" for the health and wellbeing of New Hampshire's children, including the wish that "New Hampshire will match our neighbors to the south (Massachusetts) who have a 1% uninsured rate for their children."
Board Chair Martha McLeod's message noted that "the Board is committed to continuing Sandi’s legacy of focusing on community needs and promoting collaboration. 2014 will be a year of self-reflection in which we will explore opportunities for having the greatest impact with our resources. We’re in a good place for this transition. We have a capable Interim President in Patti Baum, our funding goals and processes are well established, and our grantees are doing valuable work.
"It is extremely gratifying for the Board to see the Foundation’s investments pay off," Martha notes. "The passage of Medicaid expansion by the New Hampshire Legislature this spring gave us much cause for celebration. In 2013, the HNH Foundation devoted substantial financial and staff resources to expanding health care coverage for New Hampshire’s most vulnerable families and children. We are delighted and proud that those efforts are bearing fruit."
Read the full 2013 Annual Report, which includes a detailed summary of the Foundation's 2013 Grants and Contracts, which totaled $686,957.
HNH Foundation Program Officer Patti Baum Named Interim President
The Search Committee of the Board of Directors of the HNH Foundation has announced that Patti Baum, Program Officer, will serve as Interim President when Sandi Van Scoyoc, the current Foundation President, retires in April. Ms. Baum has worked at the HNH Foundation for six years, managing its grants program that awards over $600,000 annually throughout New Hampshire. The HNH Foundation is New Hampshire’s leading funder dedicated to increasing health and dental insurance coverage for children, promoting children’s oral health and preventing childhood obesity. She will resume her role as Program Officer once a new President is selected.
Prior to joining the HNH Foundation, Ms. Baum served as Health Promotion Manager at the Division of Public Health Services, NH Department of Health and Human Services (DHHS).
In announcing Ms. Baum’s appointment, HNH Foundation Board Chair Martha McLeod stated that “we have full confidence in Patti’s ability to lead the Foundation as we, the Board, take additional time to assess the most effective structure for our organization moving forward.
While we had expected the appointment of a new CEO this spring, we have revised that timeframe. This is a perfect time to assess the Foundation’s operations and structure, and provides us with a unique opportunity for introspection.”
The HNH Foundation’s Board of Directors Search Committee is made up of Board members Tyler Brannen, Shannon Mills, Martha McLeod, Steve Paris and Elaine Van Dyke.
On Track and Moving Forward
Lessons Learned from the Implementation of Consumer Assistance for the New Hampshire Insurance Marketplace: October 1-‐December 31, 2013
The January 2014 report prepared by CHI (Community Health Institute), under contract with the HNH Foundation, provides a comprehensive overview of the progress being made in health insurance outreach and enrollment efforts in New Hampshire. It also suggests action steps for February and March. Download the full report.
Project Purpose: Provide a report of New Hampshire’s (NH) progress in implementing thehealth insurance marketplace between October 1 and December 31, 2013. This report provides a complete picture of what is happening in the state, across organizations. Key findings may be used to tweak plans and practices to increase the efficiency of future enrollment periods.
Key Findings from October-December 2013
1. Outreach and enrollment efforts were complicated by three external factors: technical difficulties associated with HealthCare.gov and the rollout of the Affordable Care Act (ACA), the decision not to expand Medicaid eligibility, and the concurrent transition to Medicaid managed care in NH. As a result of the complications with HealthCare.gov, partners focused on building outreach and enrollment infrastructure until December, when enrollments began to rapidly increase.
2. With 11,446 enrollments, NH was one of ten states that met the Center for Medicare and Medicaid Services (CMS) projected number of enrollments during the first three months. This amounts to 60% of the 19,000 enrollments projected between October 1, 2013 and March 31, 2014. NH compared favorably with national statistics on total enrollment, but a smaller percentage of NH enrollees were young (22% vs. 24%) and NH experienced a slower rate of new Medicaid enrollments due to the lack of Medicaid expansion.
3. Slightly less than three-quarters (72%) of new enrollees in NH received federal financial assistance, compared to 79% at the national level, suggesting a need for outreach to lower-income NH residents. With one insurance issuer, the average monthly premium for the lowest cost Silver plan in NH is $359 compared to $310 at the national level.
4. An early effort by NH Health Plan to place assisters in all areas of the state was apparently successful. Partners report that all regions of the state are adequately reached by outreach efforts, a fact which has also been made possible by collaborations between partners.
Action Items for February-March 2014
1. Prepare appropriate communication strategy to respond to questions from consumers (regarding coverage details, narrow network, and information security) and businesses (regarding the viability of SHOP plans)
2. Seek out existing collaborations between partner organizations to streamline outreach and enrollment efforts
3. Ensure media firm provides timely materials to partners
4. Expand access to assistance resources by seeking out partners with financial interests in increased coverage
5. Streamline news updates and reporting in one organization, who can then respond to publicity requests from a number of sources (e.g. government, media)
Despite a slow start and early disappointments, partners feel that efforts to implement the insurance marketplace are on track, and are optimistic about the next three months
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