January 16, 1998



STEVE SISOLAKGovernorRICHARD WHITLEY, MSDirectorLISA SHERYCHAdministratorIHSAN AZZAM, Ph.D., M.D.Chief Medical OfficerDEPARTMENT OF HEALTH AND HUMAN SERVICESDIVISION OF PUBLIC AND BEHAVIORAL HEALTH4150 Technology WayCarson City, Nevada 89706Telephone (775) 684-4200 Fax (775) 687-7570 THE DESK OF THE STATE DENTAL HEALTH OFFICER"No one can whistle a symphony. It takes a whole orchestra to play it." – H.E. Luccock Oral Health Program Mission: To protect, promote, and improve the oral health of the people of Nevada. Core Values: Integrity, Compassionate Care, Innovation, Quality, and Hard Work.In the spirit of informational transparency, I would like to present our latest projects and update you on our progress.-76200204470Education0Education Rural Nevada Expectant Mother Dental Access ProgramOver 1700 miles were traveled across Esmeralda, Nye, Lincoln, and White Pine Counties to provide information on the importance of oral health during pregnancy as part of a collaborative project with the Maternal, Child, and Adolescent Health Department through a HRSA grant. While obstetric offices were targeted, the shortage of providers in many counties lead to opening the presentation to the general public through a presentation in the library or community center of the major town in each county. Flyers from the American Academy of Pediatrics with the Division logo, a magnet with oral health tips, a hygiene kit with pregnancy reminders and Medicaid information, and a medical clearance for dental treatment mock prescription pad were designed and included as an oral health kit for each medical and community health office. Additionally, materials were available to the public during each presentation. A survey on expectant mother’s nutritional and behavioral habits and oral health status during pregnancy was also designed and disseminated. The Southern Nevada Health District has partnered with the Oral Health Program to provide the case management staff to connect expectant mothers to a dental office. Washoe County School District Clinical Services Dr. Capurro and Dr. Tongsiri met with the Director, Assistant Director, and Clinical Services Director for Washoe County Clinical Student Health Services who provide oversight of the medical services for students enrolled in the Washoe County School District. This meeting was initially scheduled to discuss dental referral services for ID/DD adult students within the school district. However, after further evaluation of the school nursing systems, it was apparent that the school nurses were eager for oral health education and that the opportunity existed to complete oral assessments at specific grade levels. From this meeting, it was decided that a pilot study on a set number of Title 1 schools over the SFY20, which will include a standardized method of data collection via BSS, will begin spring 2020. A full contract between agencies is in process and professional development training on oral health, dental trauma, and BSS is scheduled for all 47 school nurses in December. Licensed Childcare Oral Health Education and Basic Screening Survey The Oral Health Program has partnered with the Nevada Department of Education to launch a non-invasive open-mouth basic screening survey, create educational webinars, and build classroom toothbrush stations and protocols for licensed childcare centers throughout rural Nevada. The data collected as a part of this project will be compared to the 2017 Head Start BSS to better understand what health disparities and educational opportunities exist in rural Nevada. The contract is tentatively scheduled to be heard at the November Board of Examiners meeting. Oral Health Program Interns for 2019-2020Mr. Marc Chmiel is currently working on a project to deeper our understanding of water fluoridation and dental decay rates in Nevada. Dr. Letti Hale is currently working on a project to review health promotion and marketing techniques and will apply best practices to propose oral health message for Nevada. Conference Presentations and LecturesNevada Public Health Association: Medicaid Dental Benefits Evolve to Tackle Chronic Health Conditions in Nevada through AB22, Dr. Capurro with Assemblywoman NealNevada Health Conference: Emergency Room Redirect Pilot Program Using Teladentistry, Dr. Capurro with Dr. TongsiriNevada Health Conference: Medicaid Dental Benefits Evolve to Tackle Chronic Health Conditions in Nevada through AB22, Dr. Capurro with Assemblywoman Neal Presentation to TMCC 2nd Year Students in Community Dental Health Course on the NV Oral Health Program. Medicaid ER Redirect for Non-Traumatic Dental ConditionsWork continues on a pilot project to reduce emergency room visits for non-traumatic dental conditions at University Medical Center of Southern Nevada. In addition to the Nevada Oral Health Program, the team consists of Liberty Dental Plan, the sole Medicaid dental benefits administrator for Nevada, and the owner of Teladentistry. This program is a medical-dental integration pilot that will add a dental provider to the medical team in the ER. Contract revisions continue to meet CMS and regulatory standards. Legislative Implementation PlansAB223- the outline of the CMS 1115 Waiver continuesSB366-Medicaid chapter updates, provider mapping, benefit schedule revisions if neededServiceSpecial Olympics, Special Smiles, 2nd Annual Las Vegas Health Fair. The Oral Health Program joined UNLV School of Dental Medicine to provide oral hygiene instruction, dental screenings, and oral hygiene kits to 57 Special Olympics athletes. Please see the attachment “Outreach Opportunities” for fall activities. Additional volunteers are needed and your participation would be appreciated. InfrastructureOrganizational Strength and CapacityThis quarter, Ms. Elizabeth Chartier accepted a full time teaching position as an Assistant Professor at Ohio State University College of Dentistry. Ms. Chartier was a valuable asset to the Oral Health Program and her role will be hard to fill. Ms. Monisa Riley returned to the Oral Health Program at the end of July. Her contract has been extended until November pending continued funding. Ms. Riley provides much needed administrative and technical support for the program. Identification of funding allocation continues for FY21 contract to continue the operation of the Nevada Oral Health Program and associated positions. Quality Key Meetings Nevada State Board of Dental Examiners, petition for advisory opinion sought for clarification on the scope of practice for public health endorsed dental hygienists to place silver diamine fluoride and glass ionomer as an interim therapeutic restoration. Nevada State Board of Dental Examiners, petition for advisory opinion sought for clarification on teledentistry language and the scope of practice for dentists. ReportsMonthly report to the Chief Medical Officer Monthly inclusion of state water fluoridation data into CDC WFRS site2017 Dental Workforce Survey Report (in-progress)MCH report on Rural Nevada Expectant Mother Dental Access Program. (In-progress, due in October)Growth Grant ApplicationsHRSA 20-025, Rural Health Network Development Planning Program, a one-year $100,000 grant to increase the availability of health care services in medically underserved communities in rural Nevada through network development of critical access hospitals and community partners will be submitted in November. OHP is a grant contributor and member of the staffing plan. This year’s application will focus on creating healthcare networks for diabetic residents in rural Nevada. Dental Trade Alliance Foundation, a one-year ~$25,000 grant to fund a Northern Nevada extension of the rural Expectant Mother Medicaid Dental Access Program for Churchill, Douglas, Elko, Eureka, Lander, Mineral, Lyon, Pershing, and Humboldt Counties was submitted by OHP in May. Although the application scored high, it was not selected for funding. Determinants of Nutritional Status Among Patients with Diabetes and Their Impact on Health Outcomes, a collaborative medical-dental research project to identify the relationship between food insecurity and food deserts in Las Vegas on the oral health and overall health of patients with diabetes. OHP is a grant contributor and co-investigator along with PI, Dr. Izuora, Associate Professor of Internal Medicine at the UNLV School of Medicine and co-PI, Dr. Civon Gewelber, Director Special Care Dental Clinic at UNLV School of Dental Medicine. Oral Health Policy Priorities for the 81st (2021) Session of the Nevada Legislature Title: Appropriations Bill for the DPBH, Oral Health ProgramTitle: Screening Before School Entrance Policy Title: Expansion of Medicaid Dental Benefits for Adults Diagnosed with ID/DD Title: Expansion of Scope of Practice for Dentists to Provide VaccinationsTitle: Alignment of Medicaid Dental Benefits for Individuals Receiving Treatment in a Substance Abuse Treatment Program. Title: Expansion of Dental Services for Vulnerable and Underserved PopulationsTitle: School Based Sealant Program for NevadaRespectfully submitted,Antonina Capurro, DMD, MPH, MBANevada State Dental Health Officer ................
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