Samaritan Lebanon Community Hospital and Samaritan North Lincoln Hospital – Healthy Smiles for All

Overview

Healthy Smiles for All (HSFA) is a public/private partnership in east Linn and Lincoln counties in Oregon. HSFA is a multifaceted project that provides oral health care to uninsured, underinsured, low-income, homeless, veterans and migrant residents of the counties. It was established in 2012 as a pilot program with the Coast to Cascades Community Wellness Network, Linn County Oral Health Coalition, Samaritan Lebanon Community Hospital, Capitol Dental Care, the River Center, East Linn-Benton Federally Qualified Health Center and Samaritan Sweet Home Family Medicine to ensure that all uninsured and underinsured adults have access to emergency dental care. The HSFA project is a model that was designed after the emergency dental program of the Community and Economic Development Association program in suburban Cook County Illinois and the Colorado Co-Location project in the Denver area. The HSFA consists of three components: an adult emergency voucher program, dental van services and co-location of dental care into medical clinics.

Impact

Since the inception of the Healthy Smiles for All project in 2012, approximately 80 patients are served each year through the Linn County Adult Emergency Dental Voucher in private practice dental offices, nearly 100 are treated on the dental vans annually, and more than 800 patients are provided emergency and preventative care at the co-location sites every year.
 
As of December 31, 2016, data from emergency department and urgent care show that usage at the Samaritan Lebanon Community Hospital and Urgent Care sites were down by nearly 40 percent since the HSFA program began in 2012. Because the HSFA program is not part of a scientific study, they cannot fully attribute these reductions to the program. However, prior to implementation of the HSFA program, annual visits to the ED and UC sites averaged more than 500 each year; in 2016, that number decreased to 108 visits by uninsured/underinsured patients.

In addition, 35 Samaritan medical providers have been trained in First Tooth since 2012 and 27 Samaritan medical providers were trained in the Smiles for Life curriculum during 2016. Coordination of emergency and preventive oral health services has improved through the efforts of the local and regional oral health coalitions. And the partnership with Samaritan Lebanon Community Hospital and Capitol Dental Care to expand dental van services to the Wiley Creek Assisted Living Facility provides up to 15 seniors with dental care each month. Further, the annual marketing campaign since 2012 has resulted in more than 150,000 people in the region exposed to positive oral health messages each year.

Lessons Learned

To replicate the model:

• Develop a strong and committed coalition that has a focus on oral health.
• Conduct a comprehensive mapping exercise to determine oral health services, needs and gaps.
• Develop partnerships with multiple organizations outside of the direct work of the coalition.
• Ensure all partners support all segments of the program.
• Educate the community about the program.
• Provide staff training to the medical teams prior to locating the Expanded Practice Dental Hygienists (EPDH).
• Make certain that EPDHs are part of the medical team in the co-location sites.
• Provide proper portable equipment for the co-location sites (chairs for adults).
• Advertise the services in locations where people who need them will access the information.
• Provide outreach to local agencies to inform them of oral health services.
• Schedule dental vans in locations where people who need treatment can access the services.
• Coordinate the services with all providers.
• Provide coalition members with ongoing education, information and support.
• Revisit and adapt both the coalition and program annually.

The coalition also developed standards for the HSFA project, including:

• Treat every client with respect and dignity.
• Offer information in plain language and multiple languages.
• Provide treatment services in patients’ preferred language when possible, or provide interpretive and translation services.
• Offer services where people gather.
• Provide support to medical and dental staff.
• Offer transportation and child care to patients.
• Follow up with patients and providers.
• Meet with program staff to review and adjust services.
• Evaluate and adjust services annually.

Adherence to the standards will help improve oral health in the community.

Future Goals

The program will eventually cover both Linn and Lincoln counties; currently, only Linn County is covered. Samaritan Coastal Clinic will begin co-location dental services in July 2017. Dental van services will be offered at the veteran home located in Lebanon supporting more than 200 veterans. The Regional Oral Health Coalition is working to develop co-location services in rural Benton County in 2017. The partnership with Capitol Dental and Samaritan Health Services will allow the co-location project to be maintained in current locations.

Contact: JoAnn Miller
Director, Community Health Promotion, Samaritan Health Services
Telephone: 541-768-7330
Email: jomiller@samhealth.org