Indicator 1.2.b: Total number of emergency department visits due to ambulatory oral health conditions
Incomplete list of critical partnerships identified to address underlying factors and garner support:
Florida Association of Community Health Centers • Florida Agency for Health Care Administration • Florida Department of Health • Florida Department of Children and Families • Area Agencies on Aging • Safety net providers • Hospitals (including administrators, providers, social workers/case managers) • Dentists and dental societies • Consumer advocates (Florida Legal Services/legal aid • Rural health • At policy level: requirements for PCMH certification that requires documentation and follow up referrals for care • US. Health and Human Services (HHS) • Center for Medicare and Medicaid Services (CMS) • Health Resource Administration (HRSA) • Low income pool grants for ED navigation • Florida Dental Hygiene Association • Tribal Councils • National Dental Association • National Hispanic Association • Urban League
Health navigators in emergency rooms to provide case management, referral and follow up to dental resources in the community. • Explore best practices used in other states to increase client and provider participation in Medicaid programs • Oral health education and prevention campaign to include "when to use ED," community health resource guides yield positive results • Development of new payer/delivery models
Promote health navigators into ED to follow up • Develop new payer/delivery models (e.g. explore the development of public private partnership in the care of emergency based dental problems) Create an oral health literacy and prevention campaign aimed at use of ED, available oral health resources, benefits/coverage Implement best practices used in other states to increase participation in Medicaid programs
Story Behind the Curve
Factors that have contributed to improving the data:
There is growing awareness of the "problem" and high costs of ED Visits for oral health issues • State Medicaid (AHCA) has been charged w/ increasing access for Medicaid clients (children) which may result in an increased number of providers taking Medicaid
Factors that restrict the data:
There is a lack of access to care for both Medicaid and uninsured adults and children • A limited number of dentists participate in Medicaid • There is a lack of providers who participate in Medicaid • A lack of oral health literacy (lack of knowledge of self-care) exists • A lack of knowledge of community dental resources exists. • There is no follow up in the ED to refer for dental treatment. • People use EDs as primary care physicians (for non-emergent medical and dental issues) • There is a lack of knowledge regarding the proper use of the ED • Limited adult dental Medicaid benefit exists in Florida • There is a lack of resources for uninsured adults • There is usually no definitive treatment or follow up care for dental problems in hospital emergency rooms • There is a limited amount of sources for low cost care • Unknown status around health equity.
Educate and utilize health navigators in EDs• Establish focus groups to implement navigation in the community Create education program for when/how to use ED• Create community resource guides for dental • Partner with 211 Association to incorporate statewide oral health Identify and implement best practices for increasing Medicaid providers and expanding Medicaid benefits • Bring in national speaker to OHF about best practices • Work with AHCA to incorporate best practices into the Medicaid system resources into their its network.