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“Federal Funding for Oral Health: The Financial Model for Federally Qualified Health Centers (FQHCs).”
Successful Models of Partnership Between Schools and Health Centers
54th Annual ADEA Dean’s ConferenceNovember 12, 2012
Rick Mumford, DMD, MPH
Clinical Associate Professor
Director of DISC Program
UNC-School of Dentistry
Department of Dental Ecology
Extramural Clinical Rotation’s Role in
Community – Based Clinical Dental Education UNC - SOD and Community Health Centers
Our primary partners – NC AHECs & NCCHCA
Dentistry In Service to Community – (DISC) Program
Extramural Clinical Rotation’s Role in
Community – Based Clinical Dental Education UNC - SOD and Community Health Centers
How we make the program work - How the parts How the parts work together to achieve our respective missionswork together to achieve our respective missions
UNC – SOD DISC – Community-based
Extramural Clinical Programs:
An Educational Mission
Dentistry In Service To Communities
•DDS Students Summer 3rd Year clinical rotations – required (8 weeks)
•DDS Students All other clinical additional rotations•Student Health Action Coalition (SHAC) - Volunteer student clinic
entering its fourth decade.•DH Student practicums – required (3 weeks) many NC communities•International Projects – Students learn a global perspective of service•ENNEAD Student Volunteers – NC Public Schools, NCDS-MOM
clinics and community health fairs•Student Organizations – such as “Sealant Saturdays” Greene County
Notes: A full-time faculty or adjunct is required onsite as attending and preceptor for clinical activities. These are volunteer, non-paid adjuncts.UNC-CH partners with NC AHEC to provide AHEC housing during required clinical rotations
UNC - SOD Extramural rotations - 4th Year Students
Dentistry in Service to Communities – DISC Program
DISC PROGRAM GOALS The DISC IV extramural program has two primary goals:
•To give students an opportunity to observe and participate in a variety of oral health care delivery systems – public dental practices while providing clinical care
•To expose students to a diverse patient population, including those with special needs – which students would be unlikely to encounter in the dental school clinic - but which are represented in communities where dentistry is practiced (two 4-week rotations required; one - a public dental practice and one – a hospital rotation)Note: With course director permission, two general practice rotations are permitted
UNC-SOD DISC Students – Clinical Credit Received
Currently four departments allow clinical credit for some procedures completed on extramural rotations:
• OMFS allows up to 20 extractions
• Prosthodontics allows 2 full sets of dentures
• Pediatric Dentistry allows credit for child patients seen in pre-approved sites with boarded pedodontists
• Diagnostic Sciences & General Dentistry
Allows credit for biopsy submission
Extramural Clinical Rotation’s Role in:
Community – Based Clinical Dental Education - UNC - SOD and NC AHEC: A training mission
Our primary partners – NC AHECs & NCCHCA
http://www.ncahec.net/
8
NC AHEC Regions
DISC Sites by
AHEC Region
Extramural Clinical Rotation’s Role in:
Community – Based Clinical Dental Education
UNC - SOD and NC CHC: A healthcare access mission
Our primary partners – NC AHECs & NCCHCA
http://www.ncchca.org/
12
Dentistry In Service to Community – (DISC) Program
NC Counties served Summer 2011 Total students
78
Alamance Chatham
Cumberland Durham
Forsyth Burke
Gaston Buncombe
Greene Catawba
Granville Robeson
Guilford Wayne
Orange Wilkes
New Hanover Jones
Mecklenburg Edgecombe
Orange Moore
Person Haywood
Pitt Lincoln
Sampson Stanley
Rowan Wake
Wayne (Represents 66 active sites)
DISC Rotations 2011 – Total (156)115 Student Rotations in NC - 74% 41 Student Rotations U.S. other or international – 26%
10/19/12
1
2
3
4
5
6
7
89
10
11
12
13
14
15
1617Cherokee
Graham
Swain
Clay
Macon
Jackson
Transylvania
Henderson
MadisonYancey
MitchellAvery
McDowell
Polk
Rutherford Cleveland
Caldwell
Watauga
AsheAlleghany
Wilkes
Alexander
Iredell
Davie
Yadkin
Surry Stokes
Davidson
Stanly
UnionAnson
Richmond
Montgomery
Randolph
Rockingham Caswell
Wayne
Scotland
Hoke
Robeson
Columbus
Brunswick
Pender
Bladen
Cumberland
Moore
Lee
Harnett
Chatham
Johnston
Nash
Person
Vance Warren
Halifax
Northampton
Duplin
Onslow
Jones
Craven
Carteret
Hertford
Gates
Pasquotank
CamdenCurrituck
Bertie
Martin Washington Tyrrell Dare
HydeBeaufort
Pamlico
Haywood
Buncombe
Burke Catawba
Lincoln
Gaston
Mecklenburg
Cabarrus
Rowan
Forsyth
Guilford Alamance
Orange
Granville
Durham
Franklin
Wake
Sampson
Lenoir
Greene
Pitt
Wilson
Edgecombe
NewHanover
DISC Rotation Sites in North Carolina by County
42 Blue Counties indicate presence of DISC Sites
66 Active NC DISC Sites
Dentistry In Service to Community – (DISC) Program
Community Health Centers - 2012Outside NC:
Colorado - Peak Vista CHCGeorgia - Good Samaritan - AtlantaMaine - Penobscot CHS (some others less often)
Key Program Costs $:
•Staffing – 2 FTEs (1-Faculty, 1- Staff)•Student Stipend (Inside NC ↑ 35 miles)•Housing (Inside NC ↑ 35 miles)•Preceptor Annual C.E. Event•Travel (New sites, Troubleshooting)•Misc.
Cost Estimates $:
•Staffing = ~ $250,000•Student Stipend = ~ $18,000•Housing = ~ $6,000 ($5.00/night)•Preceptor Annual C.E. Event = ~ $5,000•Travel = ~ $3,000•Misc. = ~ $5,000Approx. $287,000 to $290,000/yr
Funding Sources $:
•Staffing – 2 FTEs – AHEC (state funds)•Student Stipend - AHEC (state funds)•Housing - SoD (state funds/Dean’s Acct.)•Preceptor Annual C.E. Event – (Dean’s Acct.)•Travel - AHEC (state funds) or Dent Foundation•Misc. - Dent Foundation
+“In-Kind Cost of Preceptors & Clinics”
Find Partners with state funding and solid network of advocates & an inter-professional mission
Maximize use of “in-kind” resources (Existing clinics and dental staffs)
Incentives to partners:Community service reports to AHECWaive fee to post job openingsReduced rate or free C.E. to preceptorsAdjunct faculty appointments (CV help)Electronic use of health sciences librariesStudent stores discountGrant letters of supportReciprocate
Funding Sources $ Free Advice:
UNC – SOD DISC Program Highlight
AHEC Annual Report—School of Dentistry 2010-20111 October 2011
Using the UNC School of Dentistry's Dental Faculty Practice fee schedule, as it more closely reflects the cost assumed by patients at private practices, the students provided $1,302,938 in dental services to underserved populations in North Carolina.
UNC – SOD: Dentistry In Service to Communities Program
DISC + CHCs & AHECs = a successful partnership
Serving North Carolina “safety net” dental clinics and helping to
expand access to oral health care across the the state for over 20
years!
Rick Mumford, DMD, MPHDirector, DISC ProgramUNC at Chapel Hill - School of DentistryCampus Box # 7450 Chapel Hill, NC 27599-7450rick_mumford@dentistry.unc.eduT - 919.966.2787F - 919.843.1170
Thank you – Questions?
SukriyaСпасибо
MerciMerci
Xièxiè nǐ!