National: This investment supports National Association of States United for Aging and Disabilities (NASUAD) to develop and administer a survey designed to improve knowledge and understanding of existing services and supports for seniors and people with disabilities, particularly in managed care environments; and increase integration and coordination of aging and disability policy with Medicaid oral health policy. Specifically, NASUAD will design a comprehensive survey on Medicaid oral health services for older adults and individuals with disabilities; incorporate questions into a survey of seniors and people with disabilities about individuals’ access to and utilization of oral health care services; convene meetings of leaders in the aging and disability as well as the Medicaid dental fields to foster collaboration between the two groups; develop a report and disseminate the findings in multiple venues; and create an online training that includes best practices regarding oral health for seniors and people with disabilities. Due to the lack of coverage for dental benefits and complex eligibility requirements between publicly funded health care programs, Medicaid represents the primary source of dental coverage for many seniors and people with disabilities. This proposed work will create a baseline of dental benefit coverage that can be compared across states and used by policymakers and advocates to develop strategies to increase coverage for and utilization of oral health services in publicly funded health plans for aging and disabled adults. $295,479 will be used to support personnel time to implement and administer the survey, engage and convene stakeholders, and develop reports; consultant services to design the written report; travel and meeting expenses; and administrative costs associated with the implementation of this work. This proposal aligns with the Oral Health 2020 Goal 1 of mandating the inclusion of an adult dental benefit in publicly funded health insurance and the target that at least 30 states have a comprehensive Medicaid adult dental benefit, and no states that currently have a Medicaid adult dental benefit roll back or eliminate that coverage. Grant funds will be paid in two installments, 50% ($147,740) on receipt of the signed Terms & Conditions and 50% ( $147,740) after receipt and approval of the 6-month interim report.

This investment supports the Center for Health Care Strategies (CHCS) to conduct a national study of access to dental care among adult Medicaid beneficiaries and to provide technical assistance (TA) to the national grantee network of the DentaQuest Foundation to support their efforts around the Medicaid target. $456,711 will support the personnel and TA capacity necessary to explore, produce, and subsequently disseminate Medicaid knowledge products.

Texas: : This investment supports the ADA Mission of Mercy with San Antonio Christian Dental Clinic and Haven for Hope Dental Clinic intend to bring awareness to the wider community and the governmental agencies that may be able to address the problem of access to dental care for underserved Texas populations, through media coverage and participation by elected officials. The ADA has made a priority for the association and their Action for Dental Health program is a three-pronged action plan to address the dental health crisis in distinct areas: Provide care now to people suffering (MOM's, Give Kids a Smile); Strengthen & expand the public/private safety net which includes working with FQHC's and simplifying Medicaid; Disease prevention adn dental health education. The ADA has a campaign Action for Dental Health that works with legislatures on issues such as Medicaid reform for reimbursement. $10,000 will support Pre-screening functions prior to the event for more efficient delivery on the MOM weekend. Grant funds provided through the Community Response Fund will improve access to care for an underserved population of San Antonio and Bexar County.

California: This investment supports Children Now to engage and partner with community stakeholders throughout Los Angeles to build the capacity of public health sites to implement the pediatric oral health action plan, build support for the restoration of the California Children’s Dental Disease Prevention Program, and develop an effective dental referral process that ensures children have access to oral health care, education, and prevention. Children Now will explore financing mechanisms for public health programs that will promote their sustainability, leverage its networks to research and develop models implemented in other states to bridge early childhood and school-based systems together, and engage primary care providers in oral health education and prevention. Through this collaborative approach, Children Now and its partners will help to strengthen the broader community infrastructure to support the inclusion of oral health in statewide policy, public health program delivery, and coordinated care practices. $200,000 will be used to support personnel time, communications, travel, meeting expenses, and consultant expenses that contribute to the implementation of this project. This proposal aligns with the Oral Health 2020 Goal 4 of eradicating dental disease in children and the target of having 75% of children reach age 5 without a cavity.

Virginia: This investment supports the Virginia Oral Health Coalition (VaOHC) to strengthen and empower the oral health network in Virginia to facilitate advocacy, education, and awareness activities. Specifically, VaOHC will provide the infrastructure and leadership to nurture and expand the current oral health network to include representatives from health systems and payers who are currently at the forefront of the changing health care infrastructure in Virginia, traditionally underrepresented minority populations, and the provider community. This expanded network will bring the additional expertise, connections, ideas, and energy necessary to enable programs and policies that integrate oral health into ever-changing health care systems. This broader network will work collectively toward the Oral Health 2020 target to "ensure that emerging patient-centered care models in Virginia include oral health" by focusing on the drivers of effective care models, care provider engagement, and effective financing models. $199,996 will support the personnel and stakeholder convening capacity needed to expand the network’s footprint and circle of influence to achieve a shared vision where oral health is integrated into all aspects of Virginia’s health care landscape.

Continued support to the Illinois Chapter of the American Academy of Pediatrics to begin the Implementation Phase of the Oral Health 2014 Initiative. Activities during implementation will include: a partnership with WIC and several other states to integrate an oral health education module into parent education programs; the development of a unified resource center for oral health information in Illinois; improvement of the fluoride varnish reimbursement program in the state; and a literacy campaign targeted at families and caregivers of young children throughout the state. Grant funds will support staff guidance of the implementation plan, overhead costs related to the execution of the plan, and consultant support to achieve the key objectives listed above.

Support to the Center for Health Care Strategies to assess state intentions around incorporating adult dental coverage into benefit packages for Medicaid expansion under the Affordable Care Act. Support of this proposal will inform the decision making process for those who are still debating the pros and cons of including dental benefits for adults and lead to enhanced coverage and access.