Grants to States to Support Oral Health Workforce Activities - DC Health's Oral Health Program requests $2,000,000 in federal funds over five years ($400,000 per year), matched at 40 percent or more by state funds, to launch innovative programs to reduce burnout and strengthen recruitment and retention in the oral health workforce serving the District's Dental Health Professional Shortage Areas. As of the 2025 licensure renewal cycle, 2,025 oral health workforce across 251 organizations renewed their license and 700 workforce across 119 organizations work in shortage areas. The District has three shortage areas: FQHCs, the Low-Income Dental HPSA east of the Anacostia River, and the downtown Homeless HPSA. DC Health has a clear understanding of workforce wellness, having embedded the Mini-Z 2.0, a validated instrument measuring burnout, work environment, work pace, and stress, into workforce licensure renewal since 2022. Workforce who respond to the Mini-Z 2.0 and report a positive work environment and work pace, and low to no burnout and stress, are scored as working in a joyful workplace. DC Health finds the highest burnout and lowest rates of joyful workplace in the safety net. Only 30 percent of FQHC providers and 34 percent of Low-Income HPSA providers report a joyful workplace, each down 11 percent from 2023. Meanwhile, District wide joyful workplace rates have increased from 43 to 45 percent between 2023 and 2025. The gap between shortage area and non-shortage area is up to 15 percent, a statistically significant and substantial difference, and a leading driver of increased turnover and vacancy in shortage areas, worsening workforce shortages and access to care. DC Health proposes to develop The District Thriving Oral Health Workforce Initiative to address these issues through five evidence based programs: Project 1 publishes an Annual Public Accounting: a District Oral Health Workforce Scorecard drawing on licensure, wellness, turnover and vacancy data, published every year of the project, presented to the Legislature and used to drive state policy. Project 2, the Workforce Wellness Learning Collaborative, enrolls safety-net organizations in tiered program of Mini-Z 2.0 consultative sessions and stipend support for a minimum of two years, growing from 4 organizations in Year 1 to 12 by Year 3 and 20 by Year 5. Project 3, the Thriving Workforce Recognition Program, awards a tiered District Thriving Healthcare Workplace designation to organizations with strong workplace conditions, reaching 10 organizations by Year 3 and 15 across at least two tiers by Year 5. Project 4 develops a Patient-Centered Dental Home designation, built with community input in Year 2, awarded to at least 5 Low-Income HPSA or FQHC sites by Year 4. Project 5, the Dental Assistant Pipeline, builds on DC Health’s HRSA-22-050 supported successful dental assistant training pilot to be adopted by partners who will train 40 new dental assistants for the safety-net workforce. By Year 5, DC Health targets an 8 percent improvement in workforce reporting a joyful workplace among participating organizations, a narrowing of the 15 percent FQHC to District gap, and lower turnover and vacancy among designated Thriving Healthcare Workplaces compared with non-participants. Using state funds not part of this grant, the DC Health will expand the scope of these projects to non-dental-shortage areas and to primary medical care, ensuring their sustainability as they become core DC Health functions.
