Grants to States to Support Oral Health Workforce Activities - The Maine Center for Disease Control and Prevention Oral Health Program (OHP) proposes Maine Dental Home Without Walls (DHWW), a five-year teledentistry-enabled workforce initiative serving children and families in three Low-Income Dental Health Professional Shortage Areas (D-HPSAs): Augusta, Presque Isle, and Lincoln. These regions experience persistent barriers to complete care, including workforce shortages, long travel distances, and fragmented referral pathways. In school year 2024-2025, Maine CDC’s School Oral Health Program (SOHP) supported on-site screenings and fluoride varnish in 299 schools and recorded 23,157 student visits. Those encounters generated 1,053 urgent and 6,183 non-urgent referrals, demonstrating both substantial community reach and the need for stronger follow-through after needs are identified. DHWW will create a State-led, regionally operating and accountability model connecting schools, primary care, Federally Qualified Health Centers (FQHCs), mobile and portable services, Head Starts, community programs, navigation resources, safety-net dental centers, and regional clinical partners. Teledentistry will function as shared practice-support infrastructure that helps to streamline workforce needs currently not being met, including but not limited to timely clinical review and coordinated referrals. Activity 8, practice support through teledentistry, is the primary allowable activity. Activities 5, 7, and 9 will support regional dental-home and community pathways, continuing and distance-based education, and innovative, nonduplicative integration of community prevention with clinical review and referral closure. Activity 12 will expand State OHP capacity through a full-time Comprehensive Health Planner I and enhanced D-HPSA workforce and service capacity tracking. Year 1 emphasizes regional surveillance, readiness assessment, workforce and referral-capacity mapping, partner engagement, and vendor-neutral workflow, technology, and data requirements. Maine will not preselect clinical sites or launch patient workflows before regional gaps and feasible roles are understood. Maine OHP partners will contribute to the safety-net clinical perspective, connect the project to Maine’s FQHC and Community Health Center network, implement and link the Maine CDC’s SOHP, and Rural Health Transformation Program technology initiatives, and support statewide systems coordination and contribute care-pathway implementation expertise. Site-specific responsibilities and capacity commitments will be formalized after readiness findings. BME Strategies will provide time-limited implementation and practice-transformation support. Partnerships For Health will conduct an independent mixed-method evaluation addressing implementation, care-pathway performance, workforce effects, costs, stakeholder experience, sustainability, and replication. Quarterly continuous quality improvement will translate data and stakeholder feedback into documented actions. Expected outcomes include timely clinical review, improved referral and treatment completion, increased continuity of preventive and maintenance care, more effective use of regional workforce capacity, stronger HPSA-level workforce information, and a sustainable model adaptable to other D-HPSAs. By Year 5, recurring functions will transition to designated State and partner systems, supported by a sustainability plan, replication toolkit, and State spread roadmap.
