Quality Improvement Fund - Preferred Family Healthcare, Inc. (dba Clarity), proposes Clarity’s Improving Access to Dental Services for Children with Neurodevelopmental Disorders (C-IADS) to expand and increase access to preventative dental and additional dental services for children with neurodevelopmental disorders (NDDs). C-IADS’ in-scope integrated medical-dental services will be directly operated by Clarity at the agency’s Federally Qualified Health Center dental clinic site in Hannibal, Missouri. C-IADS proposes to serve any child under age 21 with an NDD requesting services, with services anticipated to reach those primarily residing in Marion, Ralls, and the surrounding northeast Missouri counties. C-IADS proposes to serve 1,067 children with NDDs (Yr. 1, 400; Yr. 2, 667). C-IADS will pilot innovative approaches to delivering evidence-based and patient-centered dental services and training dental and other health center staff to advance knowledge/skills of the workforce. C-IADS will also engage and collaborate with community partners to strengthen care coordination and conduct evaluation activities to support sustainability and scalability efforts. Area children face limited access to population-appropriate routine preventative and restorative dental care/settings and to coordinated care necessary to meet their multiple and complex medical/social needs. Such barriers/gaps lead to high rates of oral disease and poor health outcomes. C-IADS will address the evolving needs of children with NDDs through the following innovations/enhancements that can be sustained and expanded following the grant period: (1) establishing tailored care environments in fixed and mobile clinic settings; (2) increasing workforce capacity; (3) supporting child and parent/caregiver care engagement; and (4) collaborating with partners for integrated and coordinated care. Proposed C-IADS service and activities will integrate evidence-based traditional and innovative practices/approaches as follows: C-IADS will establish tailored dental service environments, creating designated/adapted space in fixed and mobile settings to meet immediate and evolving sensory, physical, mobility, and other needs of children with NDDs. Examples include minor renovations (e.g., lighting, Hoyer lift) and use of equipment and supplies (e.g., ramp, adaptive toothbrushes, educational materials). C-IADS will increase workforce capacity, expanding dental service teams (e.g., hiring a Community Health Worker) and providing dental staff with training/resources (e.g., behavioral health and NDD consultation from topical experts) to increase their knowledge and skills in providing specialized dental care. C-IADS will enhance/expand delivery of evidence-based and patient-centered adaptive dental services/supports. For example, C-IADS will enhance dental procedures/workflows (e.g., desensitization visits) across the provision of routine dental screenings; treatment plans; preventative care (e.g., patient/parent/caregiver education, cleanings, fluoride treatments); and treatment/restorative services (e.g., fillings, crowns, endodontics, partials). C-IADS will also provide care coordination with the patient’s medical provider to support coordinated health care delivery and navigation/case management to coordinate care with NDD and community social service providers. The project will complete an evaluation to test innovations and document outcomes to support sustainability and scalability for use with health centers with similar communities, patient populations, or organizational characteristics, including other dental clinics operated by the applicant.
