Integration of Initiatives
MCD Public Health is committed to integrating research-based evidence and best practice standards with new opportunities and creative approaches to crafting solutions. This includes fostering connections and bridging diverse partners, exploring intersecting issues, working across content areas, and integrating efforts across organizations and professions for maximum impact. Notable examples include our integration work in school-based health service settings, as well as our cross-cutting work around oral health.
In support of the Maine Assembly on School-Based Health Care, MCD staff and consultants assessed the status of behavioral health integration among school-based health centers in Maine. We developed a document that outlined key features of the two most successful approaches to implementing behavioral health services and obtaining payment for those services. This effort was funded by the Maine Health Access Foundation and resulted in a guidance and “how to” document that was distributed to school based health centers throughout the state.
MCD Public Health was one of nine demonstration sites for the National Heart Lung and Blood Institute’s National Asthma Control Initiative to improve the utilization of asthma control best practices. Working in collaboration with health care providers associated with the Calais Regional Hospital, MCD Public Health staff assisted primary care practices to develop protocols that enhanced communication and care coordination with school-based health care providers. Initial local data suggests that we will see fewer asthma-related emergency department visits when the State data reports for 2012 and 2013 become available.
While the public health and medical journals have been accumulating a substantial body of literature on the scientific relationship between oral disease and chronic diseases, much less has been published on the financial implications of these relationships. In 2009, the Maine Health Access Foundation funded MCD Public Health to analyze health care claims data to explore the fiscal impact of care on oral and chronic disease. The results, which have been verified by external analysts at the University of North Carolina, found some compelling implications. For example, there appears to be a clear and dose-related impact of treating periodontal disease among individuals with cardiovascular disease, with three year overall savings of about 20%. MCD Public Health is committed to bringing these and other oral health findings to decision makers. Policy considerations include how to structure health care insurance purchases and benefit plans, as well as the importance of locating oral health providers in under-served areas.
MCD staff working with the Maine Dental Access Coalition became aware of provider conflicts as more oral health screening and care services were being offered in school settings. Fostering discussions among provider groups and organizations resulted in a number of new protocols being developed and implemented to improve documentation and HIPPA compliant record sharing among providers in school-based and clinic-based settings.
Cavities are caused by a virus. Since 2007 MCD Public Health has worked tirelessly to get the word out : Tooth decay is caused by the most common infectious disease in childhood and can be prevented. Poor oral health in childhood can lead to early tooth loss or periodontal disease when these children are adults. Periodontal disease contributes to worse outcomes and harder to control heart disease and diabetes. In addition to our public education efforts, MCD Public Health has gone out into the community to teach more than 500 physicians, nurses, child care providers, and social service providers about the importance of early oral health care as well as how to screen for and treat early signs of decay in young children. We have convened local meetings of the dental and physician association chapter members as a first step toward closer patient collaboration, and educated the public about the crucial role of fluoridated water in reducing oral disease.