Project Abstract Project Title: Washington’s novel approach: Expanding access to integrated oral health care for Medicaid populations living in rural dental HPSAs Applicant Organization: Washington State Department of health Oral Health Program Address P.O. Box 47848 Olympia, WA 98504-7848 Project Director Name: Patti Migliore Santiago, MAOM Contact Phone Number: 360-236-3645 (desk) E-mail Address: firstname.lastname@example.org Website Address: https://www.doh.wa.gov Funds requested $400,000 per year for four years The Washington State Department of Health will address gaps in oral health services by disseminating a new payment model to grow the oral health workforce in rural Dental Health Professional Shortage Areas (HPSAs). Currently, 37 of 39 counties are all- or partially designated as dental HPSAs, indicating residents have limited access to dental care. A 2017 Washington oral health workforce study reported that the supply of dentists declines with increasing rurality. Access to dental care is particularly limited for Medicaid clients. Washington was approved in 2017 by the Centers for Medicare and Medicaid Services to allow Rural Health Clinics (RHCs) to receive a Medicaid-encounter rate for dental services. Historically, low Medicaid fee-for-service rates have made the provision of dental care unsustainable. Following this program change one RHC served as a pilot demonstration to incorporate an integrated, sustainable dental clinic. In the following years, three additional RHCs adopted the model, all unique in their adaptation and all aided by HRSA 18-014 grant funding. To expand access to high-quality, integrated oral healthcare for vulnerable rural populations, the Department will increase the number of RHCs providing dental care to Medicaid clients in rural dental HPSAs by addressing priorities meeting the
following objectives: 1. Increase the number of dental service points-of-care in Dental HPSA RHCs from four to five by August 2023, via sub-award funding for mobile dental equipment and supplies to one RHC with a dental service line. This will allow for the demonstration of an RHC dental expansion model for the new payment model. 2. Increase the number of dental providers placed in rural dental HPSAs by 1-3 per-year by August 2026. We will work with 3RNet to assist would-be dental providers and clinicians/students with safety-net employment opportunities specific to Washington. This will enhance the efforts of those RHCs adding or expanding a dental service line and will increase the Oral Health workforce in Dental HPSAs overall. We will also explore, develop, and pilot the utilization of University of Washington dental student rotations in RHCs as a sustainable workforce pipeline strategy. 3. Increase the number of RHCs in Dental HPSAs with dental service lines, from four to potentially eight by August 2026. We will provide sub-award funding, technical support, and guidance to RHCs seeking to implement the new dental payment model.