In 1997, based on feedback from school health nurses who were employees of FirstHealth of the Carolinas at the time, FirstHealth identified dental care as the number one unmet need among low-income children in the organization’s service area. In 1998, FirstHealth established three dental care centers in strategically located areas throughout the system’s service region – a move that was outside of traditional health care system boundaries.
Today, these centers provide comprehensive dental care to underserved children up to age 21. The flagship office in Southern Pines (Moore County) opened in October 1998; the Troy (Montgomery County) office opened in January 1999, and the Raeford (Hoke County) office opened in October 1999. In addition to the full-time, FirstHealth-employed dentists, private dentists from the community help provide services. Further, a community dental-supply drive is held each spring.
Since 1998, more than 28,000 unique children have been served, through approximately 11,000 patient visits annually. The impact of FirstHealth Dental Care has been significant and measurable. The latest comprehensive statistics reveal that the percentage of kindergartners with decayed teeth has decreased since the opening of the clinics in all three counties. Moore County’s kindergarten decay rate went from 23 percent to 17 percent; in Hoke County, the rate decreased from 33 percent to 11 percent; and in Montgomery County, the reduction went from 38 percent to 21 percent. The state average is 23 percent.
Over the last 12 years, the percentage of Hispanics in the patient population has increased from 16 percent to 34 percent. As a result, FirstHealth has found that full-time, bilingual staff members are necessary to meet the needs of the Spanish-speaking population and to increase dental health literacy.
Additionally, since 2009, Medicaid reimbursements have decreased by almost 10 percent. Concerted efforts to reduce expenses have been successful, as well as operational initiatives to increase efficiency by better matching staffing with patient demand. With changing demographics and decreasing Medicaid reimbursements, the lesson learned is that the clinic must continuously be innovative and re-create itself to remain financially sustainable in the ever-changing health care environment.
Because transportation and low levels of oral health literacy remain a problem, particularly in the more rural Montgomery County, FirstHealth has made improving access to dental care in this community a top priority. Accordingly, plans have been initiated to integrate dental care into existing school-based health center operations in Montgomery County to provide children access to care on school campuses, during school hours.
Contact: Chris Miller
Administrative Director, Community Health Services