p3Dental Solutions

1
p3 Dental
Solutions
Oral Health Service Expansion Grants
Kentucky Primary Care Association
p3Dental Solutions
LEAN SIX SIGMA CONSULTING
Productivity. Performance. Proficiency.
October 19th, 2010
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Expanding Oral Healthcare Access
In Kentucky
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AGENDA

• HRSAs Office of Strategic Priorities
• The Executive Summary
• Responding to Guidance
• Selection Process
• Need
• Response
• Evaluative Measures
• Impact
• Resources/Capabilities
• Support Requested
• Resource Contacts

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FQHC Health Center, 2002 2007 Unduplicated
Dental Patients
HRSAs Office of Strategic Priorities
Data Source HRSA/BPHC Uniform Data System, 2002
2007
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HRSAs Office of Strategic Priorities
Existing and Expanding FQHC Sites
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Health Centers Onsite Preventive Dental Services
HRSAs Office of Strategic Priorities
Data Source HRSA/BPHC Uniform Data System, 2002
- 2007
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The Executive Summary

• Date of Release November, 2009
• HRSA Targeted 7.5 Million
• HRSA Expects to Award Approximately 30 Grants
  Totaling 7.5 Million to Increase Access to Oral
  Health Services by Establishing or Expanding Oral
  Health Services.

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The Executive Summary

• Grants will not exceed 250,000 per year in both
  Year 1 and 2
• Applicants may propose to provide Oral Health
  services onsite
• or through a contractual arrangement to
  provide services at an
• off-site location, new site or expand their
  sites.
• Oral Health Service Expansion is not an
  opportunity to request
• financial support to serve a different
  target population
• Available to the following
• Community Health Centers (CHC) section 330(e)
• Migrant Health Centers (MHC) section 330(g)
• Health Care for the Homeless (HCH) section
  330(h)
• Public Housing Primary Care (PHPC) section
  330(i)

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Responding to the Guidance
Tell Your Story Use Jeopardy Answers Be
Specific Answer Every Question, Even Twice
Have Reliable Data
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Selection Process
Scoring of Your Application

• Division of Independent Review
• Score Adjustments
• Preferences
• Other Factors

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Selection ProcessApplication Criteria
Applicants should organize the program narrative
using the following six section
headers   Crtierion 1 Need (15
POINTS)   CRITERION 2 RESPONSE (35
pOINTS)   cRITERION 3 EvaluatIVE MEASURES (10
points) cRITERION 4 Impact (10
points)   CRITERION 5 Resources/Capabilities
(20 points)   CRITERION 6 SUPPORT REQUESTED (10
POINTS)  
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Need(15 Points)

• Service Area Description
• Type of Area
• Dental Health Professional Shortage
• Area (DHPSA)
• Target Population
• Unique Demographic Characteristics
• Special Populations
• Oral Health Status
• Identification of Patient and Visits that Will
• Receive Oral Health Services

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Need

• 4. Oral Health Service Providers
• Significant Barriers and Gaps in Services
• Behavioral Health-Related Issues
• Understanding of the Health Care Environment
• State Reimbursement Environment
• Barriers or Problems with Reimbursement

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Need

• Avoid Statements of Generalities in
• Your Need Findings
• There is Great Need to Serve More than
• 10,000 Low-Income Uninsured Residents
• in the Southern Berkshire Region
• Additional Medical Personnel who Focus on
• Primary Care are Needed.
• More than 80 of these Low-Income Uninsured
• Respondents are Willing to Use a New Free
  Clinic

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Need

• Dental Safety Net Populations Assessment
• Review of Federal and State Data
• Existing Health Care Research
• Commissioned Expert Demographic
• Analysis of US Census Data
• Interview of Health Care Providers and
• Community Leaders
• Survey of Allied Community Resources
• about Unmet Medical Needs

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RESPONSE (35 points)

• Applicant s Proposed Plan of Expansion or
• Establishment
• Provide Oral Health Care Services
• Location of Site
• Dental Lab Arrangements
• Appropriateness of Arrangements
• Linkages, Collaborations, Partnerships
• Service Contracts

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RESPONSE
3. Informing the Target Population of Services
(Marketing of Services, namely Prevention,
Intervention and Education 4. How Oral Health
will be Integrated with the Health Centers
Primary Health Care Services 5. How Oral Health
Services will Account for Needs of the
Cultural and Linguistically Diverse Patients
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RESPONSE

• Off-Site Referrals
• Special Populations
• Proposed Staffing
• Recruitment
• Project Management
• Up and Running in 120 days
• Plan for Long-Term Viability
• .

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RESPONSE
12. Proposed Quality Improvement Plan 13.
Tracking Oral Health Care Patients
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EvaluatIVE MEASURES (10 Points)

• Identify Performance Measures
• Healthcare
• Business Plan
• Performance Impact to the Overall Healthcare
  Center
• 3. Tracking Patient Treatment Outcomes Overtime

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EvaluatIVE MEASURES (10 Points)

• 4. Performance Implementation Protocol
• Goals and Data Collection

Practice Metrics
Gross Charges Number of Sliding Fee Patients
Net Revenue Number of Fee For Services Patients
Expenses (Direct and Indirect) Average Patients Seen/Day
Total Number of Visits Clinical Hours per Day/Month
Revenue per visit No-Show Rate
Cost per visit of Emergency Patients
Number of Transactions (by ADA Code) of Work-In Patients
Number of Completed Patients Total of Clinical Days Practice
Number of New Patients of Days at Full Clinical Operations
Number of Unduplicated Patients Days to Next Patient Appointment
Number of Hygiene Recall Patients of Billable vs. Non-Billable Visits
Number of Medicaid Patients Dental Supplies (Monthly)
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impact (10 Points)

• CHC Demonstrated Experience
• and Expertise in Providing Services
• Working with Target Population
• Addressing the Needs of Target
• Population
• Developing Appropriate Community
• Systems and Services
• D. Community Collaboratives

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Impact
2. How the Applicant Organization Will
Reduce or Eliminate Existing Barriers and
Increase Access to Oral Healthcare 3.
Formal and Informal Collaborations with other
Healthcare Institutions, FQHC, FQHC-Look
Alikes and Community-Based Centers
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Within a Community of Need
Impact
Head Start Pilot Program 2008
Students Screened 60
Total of Patients In Treatment 48
of Areas of Decay 240
Total Cases Completed 31
City of York School Sealant Program 2008
Students Screened 286
Sealants Placed 893
Untreated Decay 42.8
Urgent Dental Referrals Made 25
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Resources/Capabilities(20 Points)

• Location of the Oral Health Center
• Existing Healthcare Program Services
• Availability and Accessibility of Space
• For an Oral Health Center
• Current Programs Assets to Support Development
• Site Map and Floor Plan
• Relation to Existing Service Centers

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Resources/Capabilities

• Support and Commitment from Key Stakeholders
• Internal-
• Executive Board
• Executive Director
• Core Management
• External-
• Healthcare Resources
• Community, Partners
• Other Government Programs

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SUPPORT REQUESTED(10 POINTS)

• Budget
• Level of funds total resources necessary
• Maximization of non-grant revenue
• Users/encounter data productivity
• Patient care income
• Cost/user/encounter
• Total dollars/user

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HRSA Averages and Recommendations (UDS 05)
SUPPORT REQUESTED
Practice Metrics Benchmark Averages
Productivity Days/Yr (Hours/Yr) 200 work days (net 1600 hrs)
Patients/Hr 1.6
Number Patient Visits/Patient 2.2
Unduplicated Patients 1,000
Total Revenue Generated /FTE Dentist 300,000
Total Revenue/Visit 117
Encounters/FTE Dentist 2564
Encounters/FTE Hygienist 1600
of Dental Operatories (Chairs) 2
of Dental Assistants 1.5
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SUPPORT REQUESTED
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SUPPORT REQUESTED

• Rationale for New Equipment
• Cost of Non-Reimbursement Services
• Leverage of Federal Funds
• Cost-Effectiveness

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Resources
http//www.dentalclinicmanual.com/ Expanding
Access to Dental Care Through Californias
Community Health Centers www.chcf.org/resources/do
wnload.aspx?id7B2F0B8A3C-D0B2... Growing and
Sustaining a Dental Clinic within the Primary
Care Safety Net www.mchoralhealth.org/presentati
ons/NOHPC2006/S_Russell.pdf
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Forms, Forms, and More Forms

• The program-specific forms are located in
  Grants.gov
•  
• BPHC program-specific forms 1A, 1B, 2, 3, 5A.5B
  and 12 must be included
• Form 1 General Information Worksheet and BPHC
  Funding Request Summary
• Form 2 Staffing Profile
• Form 3 Income Analysis Format for Years 1 and 2
• Form 5A This form needs to be completed for the
  proposed changes in the mode of service delivery
  for the specific service expansion category.
• Form 5B This form needs to be completed only if
  the applicant organization is proposing to serve
  a new service area.

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Resource Contacts

• Jay Anderson, DMD,MHSA
• Chief Dental Officer
• Health Resources and Services Administration
• 5600 Fishers Lane, Room 6C-26
• Rockville, MD 20857
• Phone [phone]
• Fax [phone]
• Email JAnderson_at_hrsa.gov
•  

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Resource Contacts

• Tiffani Redding
• Public Health Analyst
• Bureau of Primary Health Care
• Office of Policy and Program Development
• Telephone [phone]
• Fax [phone]
• Email TRedding_at_hrsa.gov
• Technical Assistance Resources
  www.hrsa.gov/grants/technicalassistance/sexp.htm

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p3Dental Solutions, LLC 5405 Tuckerman Lane Suite
910 Rockville, MD 20852 W 240-330-6226 info_at_p3
dental.com jamespatsis_at_hotmail.com www.p3dental.co
m
Better practice performance and productivity
is not simple or easy and proficiency is
beyond just a matter of design, less becomes
more when you waste less.