Current Oral Health Workforce: Trends and Models

Diane Brunson, RDH, MPHSeptember 27, 2012

Objectives

• Describe national oral health workforce trends and their applicability to Colorado

• Outline how dental care financing impacts workforce trends

• What is the role of non-dental providers in oral health?

Dental Care Financing

• Procedures rather than disease diagnosis

• 22% of Colorado children are dentally uninsured

• No cost shifting

Dental Insurance

• Uninsured do not get dental care - usually

• 22% of INSURED also do not get needed care because of cost

• No grant funds to cover uninsured care

• Dental care financing credit card schemes

Relative Value Units (RVU)

CIVHC

• Focus Areas:– Data and transparency– Payment Reform

– Delivery system redesign• Palliative care• Care transitions

U.S. Dental School Applicants and First-Year Enrollment Trends 1980 - 2008

Source: American Dental Education Association, U.S. Dental School Applicants and Enrollees, 2007 and 2008 Entering Classes

Scho

ol 1

Scho

ol 2

Scho

ol 3

Scho

ol 4

Scho

ol 5

Scho

ol 6

Scho

ol 7

Scho

ol 8

Scho

ol 9

Scho

ol 1

0Sc

hool

11

Scho

ol 1

2Sc

hool

13

Scho

ol 1

4Sc

hool

15

Scho

ol 1

6Sc

hool

17

Scho

ol 1

8Sc

hool

19

Scho

ol 2

0Sc

hool

21

Scho

ol 2

2Sc

hool

23

Scho

ol 2

4Sc

hool

25

Scho

ol 2

6Sc

hool

27

Scho

ol 2

8Sc

hool

29

Scho

ol 3

0Sc

hool

31

Scho

ol 3

2Sc

hool

33

Scho

ol 3

4Co

lora

doSc

hool

36

Scho

ol 3

7

$0

$10,000

$20,000

$30,000

$40,000

$50,000

$60,000

$70,000

$80,000

Anschutz Medical CampusSchool of Dental Medicine State Appropriation per Student FY

2008-2009 Compared with the other Public Dental Schools

Mean = $30,536

Colorado = $11,784

Race and Ethnicity

Dental Hygiene Education Programs: 2008 - 2009

University or Four-Year College Community or Junior College

Technical College or Institute

Vocational School

Other

School of Allied Health

Sciences

Dental School Separate Dental

Department

Other University or

Four-Year College

Institutions 30 23 3 0 175 34 4 12

Capacity 1,029 840 134 510 4,446 925 180 626

Enrollment (First-year)

987 723 129 450 4,252 802 84 263

Diploma Certificate Associate Degree Baccalaureate Degree

Baccalaureate Degree in Dental

Hygiene

Other Total

N % N % N % N % N % N % N %

1 0.3 6 2.0 247 82.1 9 3.0 28 9.3 10 3.3 301 100

Source: American Dental Association, 2008-2009 Survey of Allied Dental Education, Table 2 and Table 5

2009 Dental Hygiene Job Market& Employment Survey - ADHA

Workforce Data

Access to Care

“Midlevel” Providers• Dental Health Aide Therapist

– AAPHD Curriculum: JPHD– http://www.dentalboard.state.mn.us/Default.aspx?tabid=1165

• Community Dental Health Coordinator– http://www.ada.org/4925.aspx

• Advanced Dental Hygiene Practitioner– http://www.adha.org/downloads/competencies.pdf

• Extended Care Permit Hygienist III – KS– http://

kslegislature.org/li/b2011_12/measures/documents/summary_hb_2631_2012.pdf

• Advance Function Dental Auxiliary – WA– http://www.wsda.org/

• Study re: new provider - CA

www.niioh.org

Smiles for Life

Only in certain circumstances

States with MEDICAID Funding for Physician Oral Health Screening and Fluoride Varnish

Medicaid coverage approved

Version: 8/11

Approved but not fully implemented

Reimbursement not yet approved

DERI

NJ

DC

WA

OR

CA

NV

AK

HI

ID

MT

WY

UT

AZ NM

ND

SD

NE

CO KS

TX

OK

MN

IA

MO

AR

LA

WI

IL IN

MI

MS AL GA

TN

KY

OHPA

NY

ME

FL

SC

NC

VAWV

VT

NHMARI

CTNJDEMD