Emergency Department Partners with Community Volunteer Dental Program

Muskegon County ED refers people to a volunteer dental program that offers basic services in exchange for volunteer work in the community

The Issue

In 2009, there were over 13,000 Muskegon County, Michigan, low-income residents who were uninsured or underinsured. These residents have unmet healthcare needs including the inability to pay for dental treatment. These residents are veterans, retired and working families, and people with disabilities. Once provided with access to high quality dental care and oral health education, it can decrease the number of people who utilize the hospital emergency department (ED) for dental emergencies and improve the overall health of our community.

The Muskegon County Oral Health Coalition wanted to assess how many residents were using the ED for oral health concerns. The coalition drafted a report using hospital data and sent it out to all stakeholders in the area. At the same time, the Volunteer for Dental program was created and piloting began.

What We Tried

Volunteer for Dental (VFD) began as a pilot study in 2011, modeled after The Dentists Partnership in Calhoun County, and opened to the public in January 2014. VFD offers basic dental services to residents who qualify, in exchange for completing volunteer work in the community. Participants receive their dental services at local private dental offices that provide all of the dental care for free.

Participants earn $25 in dental services for every hour they volunteer.

  • To qualify, a participant must be a Muskegon or Oceana County resident, lack dental insurance, and earn 250% of poverty or less (based on household income).
  • Participants are required to attend an oral health education class prior to receiving dental care and are coached over the phone by a registered dental hygienist as they go through the program.

Those who go to the hospital emergency department for a tooth issue are referred to the program. VFD calls all referrals and works with patients to find them a dental home. Through this process, a dental information center for the community has been created. Anyone can call and get help finding dental services or help getting dental related questions answered.  Patients are also referred by primary care physicians’ offices, dental offices, community organizations that provide medical navigation, volunteer organizations, 2-1-1, churches, the program website, Facebook, friends, family and brochures in the community.

The program coordinator, who is a registered dental hygienist, provides oral health education and resources to many organizations in the community as requested. VFD also partners with the Muskegon County Oral Health Coalition to make sure there is an oral health presence at community events throughout the year. VFD provides oral health screenings, fluoride applications, oral health education, and referrals to a dental home. Some example sites used to increase the community oral health presence are:

  • Health fairs
  • Senior living and senior community centers
  • Elementary school orientations and kindergarten roundup
  • Food trucks
  • Libraries during story time
  • Play and learn groups
  • Pregnancy center
  • The shopping mall

A key component to this program is how the load is shared equitably among dentists participating so that no one dentist bears an undue burden. Nineteen local, private dentists have agreed to volunteer basic dental services to qualifying residents. Dentists choose how they would like to participate by agreeing to offer any or all of the following services: x-rays, exams, tooth removal, fillings, and cleanings (preventive services). The program has two oral surgeons, three endodontists and one periodontist participating and offering services above the basics when appropriate.

Click to see full poster details.

Impact

The community has received a 300% return on investment with VFD since the program opened in January 2014. Highlights include:

  • 1,288 people called the dental information center
  • 15,287 volunteer hours completed by program participants
  • 2,229 dental procedures provided by volunteer dentists
  • 413 people received dental services
  • $781,267 total value back to the community

In 2016, the total visits reported from the Muskegon County ED’s for dental issues decreased from 2455 reported in 2103 including the Uninsured and Medicaid cases. The dental costs to Mercy Health also decreased from $467,400 to $374,725. The program contributed to this decrease by providing access to care and offering navigation services to residents who need dental services.

Many stories and testimonials have been shared with VFD staff about how the program has changed their life physically, emotionally and mentally.  Participants report increased self-esteem and confidence, living a more active lifestyle, finding jobs, being more connected to their community and making new friends, as positive outcomes of participating in the program.

Tips

This is a community program therefore, networking with the community is critical to its success.  Dental offices, volunteer organizations, many healthcare providers, and others, all work together for success. Connect with local dental associations, oral health coalitions, community health workers, social workers, nurses and physicians to find partners. Also, don’t forget about marketing where people meet in the community such as churches, YMCA and popular area events.

Be sure to do year-end surveys of program participants and dentists to continue to improve the outcomes and experiences for everyone.

Challenges

Marketing and spreading the word to people about the program has been one of the biggest challenges.  Using local marketing tools and systems seems to be the most effective, as well as social media.

VFD has found that just over half of the participants are 60+ years old and decided to advertise in the local Senior Perspectives free magazine. Another option that addresses this challenge is to also advertise in the local library newsletter. Working with the local physician’s network VFD was able to get information into all PCP’s offices without physically going there in person. Ask program participants to take program information around the community and give them volunteer hours for doing so.  Call 2-1-1 is the local community information center critical to connecting patients to these types of services. There may be a similar special service phone number in other communities to connect people locally.

Transportation is challenging for a number of people in the program. VFD offers bus passes for free to those who require it however, it can take two or more hours depending on transportation. This will be an on-going issue that will require continual modifications to find viable solutions.

Background

Access Health, Inc.’s mission is to provide creative/innovative health and coverage solutions that drive affordable, high, quality, excellent care experiences that lead to optimal health. Volunteer For Dental under the fiduciary arm of Access Health, Inc. encourages healthy and productive lives by creating pathways to a dental home. The vision is to ensure access to high quality, affordable dental care and increase oral health literacy and knowledge for all. Access Health, Inc. believes in the value of each individual regardless of financial worth. The VFD program provides more volunteers and community engagement, helps improve the lives and health of our residents while helping reduce overall healthcare costs.

Volunteer For Dental
1200 Ransom Street
Muskegon, MI 49442
231.766.7129
www.volunteerdental.org

Suzanne Tanis, RDH, BS, Program Coordinator
[email protected]

Jackie Lindrup, RDH, MEd, Program Director
[email protected]

Authors

Suzanne Tanis, RDH, BS
Program Coordinator, [email protected]

Jane Grover, DDS, MPH
Director, Council on Advocacy for Access and Prevention, [email protected]