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MCHB-Funded Projects

Networks for Oral Health Integration within the Maternal and Child Health (MCH) Safety Net

The purpose of the Networks for Oral Health Integration within the MCH Safety Net is to improve access to and delivery of comprehensive, quality oral health care for infants and children by testing and establishing models of care utilizing three collective strategies:

  1. Enhanced integration of oral health care within MCH safety net services.
  2. Increased knowledge and skills among health professionals (including oral health, non-oral health clinical, and non-oral health support service professionals) for delivering optimal oral health services.
  3. Increased knowledge and awareness of preventive oral health practices among parents and other caregivers to increase adoption of these behaviors including use of needed oral health services.
COHSII-NOHI Overview
Overview of Networks for Oral Health Integration within the MCH Safety Net

NOHI projects map

Each network comprises the recipient and MCH safety net sites located across four different states.

Oral Health Care Transformation for Babies (OHCT4B): District of Columbia, Maryland, New York, and Virginia

The network lead is the Health Center Network of New York (HealthEfficient) working in partnership with the DC Department of Health, the Regional Primary Care Coalition (Maryland), the Schuyler Center for Analysis and Advocacy (New York), and the Virginia Oral Health Coalition. The network is also partnering with the DC Primary Care Association and the Mid-Atlantic Association of Community Health Centers to assist in recruiting community health centers (CHCs) and with the University of Maryland to lead outreach and education activities.

The project will target infants and children from birth to age 2, their parents and other caregivers, and pregnant women at CHCs in the District of Columbia, Maryland, New York, and Virginia.

The project goals are to (1) increase oral health competencies for all relevant CHC health professionals serving the target population, (2) increase CHCs’ capacity for oral health case management and interprofessional collaboration to better address oral health risk factors and needs of the target population, and (3) ultimately, increase the proportion of infants and children from birth to age 2 who have access to preventive oral health care and of children who are caries free (no caries experience) at age 3.

To accomplish these goals, the network will develop, implement, continuously evaluate, and improve a model of care for the target population. Using the Breakthrough Series Collaborative model developed by the Institute for Healthcare Improvement, the network will lead three 18-month learning collaborative (LC) cycles. The project will invite approximately 10 CHCs to participate in each cycle, for a total of 30 CHCs during the funding period. Trainings will be designed to improve health professionals’ and CHCs’ core competencies in the following categories: (1) evidence-based oral health practices, (2) communication and education, (3) interprofessional collaborative practice, and (4) health information technology integration and optimization of quality improvement data.

Midwest Network for Oral Health Integration (MNOHI): Illinois, Iowa, Michigan, and Ohio

The network lead is the Michigan Primary Care Association working in partnership with the Illinois Primary Health Care Association, the Iowa Primary Care Association, and the Ohio Association of Community Health Centers. The network is also partnering with state oral health programs in Iowa and Michigan and the IFLOSS Coalition of Illinois. The National Network for Oral Health Access will conduct outreach and education activities.

MNOHI will improve access to and delivery of comprehensive, quality oral health care for children, ages 6 to 11, who live in communities served by one of the community health centers (CHCs) participating in the network in Michigan, Iowa, Illinois, and Ohio. MNOHI will implement efforts at 21 CHCs in years 1–3 and will expand to 50 CHCs by the end of year 5.

MNOHI’s goal is for children in the targeted communities to have an integrated medical/dental home. MNOHI will build on efforts to improve oral health care in the network states as well as on national initiatives such as the National Oral Health Innovation and Integration Network. The MNOHI model will incorporate the five domains of the oral health clinical core competencies: (1) risk assessment, (2) oral health evaluation, (3) preventive interventions (e.g., fluoride varnish application, dental sealant application), (4) communication with and education of health professionals and of parents and other caregivers, and (5) interprofessional collaborative practice.

MNOHI’s secondary goal will be to disseminate best practices related to integrating oral health care into CHCs. In addition, MNOHI will seek to publish lessons learned and evaluation findings to inform other states seeking to integrate oral health care into primary care settings.

Innovative aspects of the project will include teaching primary care health professionals to provide children with preventive oral health care; hiring community health workers to make referrals to dental clinics and follow up with parents and other caregivers; and using tools to obtain patient and program data from participating CHCs.

Rocky Mountain Oral Health Network (RoMoNOH): Arizona, Colorado, Montana, and Wyoming

The network consists of Denver Health, Office of Research (lead) and the University of Colorado, Department of Family Medicine (co-lead) working in partnership with the American Academy of Pediatrics; the National Network for Oral Health Access; and primary care associations in Arizona, Colorado, Montana, and Wyoming. Additional network partners include Colorado’s Cavity Free at Three program and FrameShift Group.

RoMoNOH will focus on primary prevention of dental caries in infants and children from birth to age 2 who are receiving health care in 30 community health centers (CHCs) throughout Arizona, Colorado, Montana, and Wyoming.

The project will develop, implement, and validate an oral-health-integration change package and toolkit to support the integration of oral health care into CHCs. Project staff will provide CHCs with technical assistance on adapting their electronic systems to ensure collection of quality-improvement metrics and on creating oral disease registries for population management. The change package and toolkit will include integration approaches that support coordinated, co-located, and fully integrated models. The project will leverage educational resources and develop new eLearnings, as needed, to transform practices. The project will also test a value-based payment approach to provide CHCs with incentives to reach quality-improvement benchmarks.

The evaluation of the project’s approach will include a cost/benefit analysis that will compare costs of implementing the models and providing integrated oral health care to benefits of providing care at the CHC and state levels. The evaluation will also examine state- and national-level policies that influence the implementation of the models and advocate for necessary change.

NOHI Portal Login

Contact

If you have additional questions or need further information about the project, please contact Susan Lorenzo, Technical Assistance and Training Project Manager/Librarian.

Resources

A User’s Guide for Implementation of Interprofessional Oral Health Core Clinical Competencies: Results of a Pilot Project
American Dental Association CDT Codes
Bright Futures: Oral Health—Pocket Guide
Considerations for Oral Health Integration in Primary Care Practice for Children
Integration of Oral Health and Primary Care Practice
Integration of Oral Health and Primary Care Technical Assistance Toolkit
Oral Health: An Essential Component of Primary Care: White Paper
Oral Health Coding Fact Sheet for Primary Care Physicians
Oral Health in Primary Care Training
Oral Health Reimbursement Chart
Oral Health Risk Assessment Resources
Organized, Evidence-Based Care: Oral Health Integration—Implementation Guide Supplement
Organized, Evidence-Based Care Supplement: Oral Health Integration—Executive Summary
Smiles for Life: A National Oral Health Curriculum