COMTREAs School Based Health Centers DR. NATHAN SUTER, DDS O R A L - - PowerPoint PPT Presentation
COMTREAs School Based Health Centers DR. NATHAN SUTER, DDS O R A L H E A L T H D I R E C T O R & D E N T I S T C O M T R E A C O M P R E H E N S I V E H E A L T H C E N T E R 4 3 0 0 G R A V O I S R D H O U S E S P R I N G S ,
O R A L H E A L T H D I R E C T O R & D E N T I S T C O M T R E A C O M P R E H E N S I V E H E A L T H C E N T E R 4 3 0 0 G R A V O I S R D H O U S E S P R I N G S , M O 6 3 0 5 1 N S U T E R @ C O M T R E A . O R G C E L L : 3 1 4 - 5 9 4 - 7 1 7 0
Located in schools or on school grounds. Work cooperatively within the school to become an integral part of
the school.
Provide a comprehensive range of services that meet the specific
physical, dental, and behavioral health needs of the young people in the community.
Employ a multidisciplinary team of providers to care for the
students: nurse practitioners, registered nurses, physician assistants, social workers, physicians, alcohol and drug counselors, dentists, dental hygienists, and other health professionals.
Provide clinical services through a qualified health provider such as
a hospital, health department, federally qualified health center, or medical practice.
Require parents to sign written consents for their children to receive
the full scope of services provided at the SBHC.
Service Delivery Types
Portable Mobile Fixed Telehealth Hybrid
Provider Groups
Private for profit FQHC Local Health Dept. Hospital University Partnership
Primary Care
Chronic Conditions OBGYN Pediatrics
Dental Care
Preventive Full Service
Behavioral Health
Counseling Psychiatry
Substance Abuse
CSTAR
Community Mental Health
Center since 1974
Federally Qualified Health
Center (FQHC) since 2012
First School Based Health
Center opened in 2013
School Based Oral Health
Screenings Mobile / Portable Prevention Follow up Comprehensive care
Tooth Fairy
PSP in all schools
Valley Clinic
Fixed Clinic – 3 chairs Comprehensive Care Adults and Children
Fox Clinic
Fixed Clinic – 5 chairs Comprehensive Care Adults and Children
Tooth Titan
Mobile/ Portable Hybrid Prevention and Exams Limited Restorative Children Only
Providers and Staff
2 Dentists 1 Child Psychiatrist 1 APN Child Psych 3 Counselors 1 Case manager 2 Hygienists 3 Dental Assistants 3 Secretaries
Dental Services
Monday-Friday
8:00-6:00
Primary Care
Coming fall 2016
Counseling Services
Monday and Tuesday
7:30 -3:00
Wednesday
7:30-6:00
Thursday
7:30-5:00
Fridays
7:30-3:00
Psychiatric Services
Wednesdays
7:30-3:00
CSTAR Substance Abuse Services
Monday-Friday
9:00-5:30
Supporting NWR1 Graduates: COMTREA’s Team Members
Lauren Willis
Dental Assistant Class of 2013
Nicole Bollinger
Dental Operations Manager Class of 2004
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Northwest R-1 District 2014-2015 PSP Data
Percent Untreated Decay Percent with No Sealant
6,700 Students
Population
2,597 Students F&R
Lunch
38.76% Free and Reduced
914 students screened 35% had untreated tooth
decay
State average 24%
82% have no dental
sealant
State Untreated Decay Average 24%
Providers and Staff
2 Dentists 2 Hygienists 3 Dental Assistants 2 Secretaries
Dental Services
Monday-Friday
8:00-6:00
Behavioral Health
Coming soon…
Nathan Suter, DDS Ashley Wegener, RDH Renee Blanken, RDH Toni Rushing, DA
Supporting Fox Graduates: COMTREA’s Team Members
Missouri Foundation for Health COHI Project
New School Based
Health Center
Largest School District in
Jefferson County
Covers 1/3 of the Jefferson
County
Highest Number of Free
and Reduced Lunch Participants
$300,000 MFH Grant
for Equipment
$400,000 COMTREA
Match for Construction
Estimated 2,000 patient
visits a year projected
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Fox C-6 District 2014-2015 PSP Data
Percentage Untreated Decay Percentage with No Sealants
11,679 Students
Population
3657 Students F&R
Lunch
31.31% Free and Reduced
1363 students screened 31% had untreated tooth
decay
State average 24%
82% have no dental
sealant
State Untreated Decay Average 24%
Valley Clinic
Cedar Springs Murphy Maple Grove Early Child NW High Woodridge Brennan Woods High Ridge
School Based Health Center: Hub & Spoke Model
& Prevention
Hygienist
identified.
cleanings and checkups stay at school.
the Community
1st like it in Missouri
needs are referred to the SBHC Clinics
complicated needs are referred to a Main Clinic.
Dental Outreach and Care Coordination Workflow
Urgent Needs Early Needs Low Needs Recalls Refer
Private Office
Free Dental Screenings performed at all but 3 Jefferson County school districts
Fixed Clinic Valley, Fox, or Hillsboro Tooth Titan Mobile Van
Single Operatory Mobile /Portable Clinic: Prevention, Diagnostics, and limited treatment.
Able to transport portable equipment to set up inside of a school.
School Dental Health
Coordinator
Part Time School District
Employee
Nurses Room Aid COMTREA provides a
vehicle
Desk inside COMTREA office Coordinates appointments Finalizes paperwork and
consent forms with parent
Communicates with school
district staff
Transports students from
surrounding school buildings Moving away from
appointment based scheduling
Coordinating different
systems of care
Mobile Telehealth Portable Fixed Clinic Hospital
Managing a population’s
care and not waiting for the patient to show up.
Grants
Missouri Foundation for
Health
HRSA – Primary Care
Expansion
Fee-for-service
Sliding fee
Medicaid
FQHC enhanced
reimbursement.
Provides sustainability
85% 11% 4%
Valley SBHC Dental Payor Mix
Medicaid % Uninsured % Comm Insurance % 50 100 150 200 250 300 Nov 2015 Dec 2015 Jan 2016 Feb 2016
COMTREA SBHCs‘ Dental Visits by Clinic
Valley Fox
Nurses are the
Gatekeeper!!
Creative ways to get
enrollment in SBHC Program.
Factor in Snow Days Simplify Paperwork School District Buy-In
Make or Break
Increase Access when
school is out.
Kids like to knock their teeth out.
CE for tooth trauma
Build on each year
Integrate into the community as a resource.
Hub & Spoke Model
Outreach
Education
Mobile
Fixed Clinic
Care Coordination
Needs assessment of schools
MO DHSS PSP Program
Grant writing to invest in initial capital for startup. Community Stakeholder buy-in.
School Board and Superintendent are KEY!!! Happy Nurses make for a good SBHC.
A robust effort to enroll students in the SBHC
Screenings, educational events, open houses, sporting events,
kindergarten registration, school enrollment packets.
Flexible Staff and Providers that want to work in a unique
setting.
School nurses are looking for dental solutions for the
“prophy mills” the majority of the time.