Grants to States to Support Oral Health Workforce Activities - Project Overview/Purpose: In response to HRSA-26-084, the Vermont Department of Health proposes to develop and implement a sustainable, community-based dental student training and recruitment pipeline that increases the number of dentists prepared to practice in Vermont Dental Health Professional Shortage Areas (Dental HPSAs). The project will move the new University of Detroit Mercy School of Dentistry partnership with Vermont practices from statewide planning into operational implementation with Vermont Federally Qualified Health Centers (FQHCs). A central part of the model is training students and FQHC care teams in minimally invasive care (MIC), an evidence-based approach that emphasizes prevention, early intervention, and preservation of tooth structure. Expanding MIC in Dental HPSAs will help participating FQHCs increase clinical capacity, reduce avoidable restorative treatment, and reach patients earlier in the disease process. Need Addressed: Vermont is one of 13 states without a dental school and faces persistent dental workforce shortages that limit access to oral health care in rural and underserved communities. Vermont had 368 dentists providing patient care in 2023, down from 393 in 2021, and access challenges are especially acute for Medicaid beneficiaries and residents of Dental HPSAs. FQHCs and private practices report difficulty recruiting providers, while wait times and limited Medicaid participation continue to reduce access to routine and preventive dental services. Proposed Services/Activities: The project will prepare participating FQHCs to serve as community-based clinical training sites for UDM dental students, with education and implementation support for minimally invasive care built into clinical rotations. Activities include FQHC readiness assessment, site-specific implementation planning, affiliation agreement and credentialing support, shared onboarding materials, role expectations, workflows, student rotation coordination, and ongoing feedback to improve the model. Through MIC, participating FQHCs will increase preventive and early-intervention services and enable providers to work efficiently at the top of their license. The project will also create recruitment and mentorship activities connecting UDM students and graduates to FQHC employment and practice opportunities in Dental HPSAs. Target Populations: The project targets UDM dental students preparing for clinical training, FQHC dentists who will serve as mentors and clinical preceptors and Vermonters living in Dental HPSAs. The patient population includes Medicaid beneficiaries, rural residents and FQHC dental patients who face limited provider availability, long wait times, reduced access to dentists accepting Medicaid, transportation barriers, cost concerns and complex health or social needs. Partners/Implementation Approach: VDH will provide grant oversight, workforce data, oral health expertise, and alignment with Dental HPSA needs. Bi-State will serve as the lead implementation partner, coordinating FQHC engagement, project management, technical assistance, partner communication, and evaluation. UDM provides the academic training partner and dental student pipeline. VSDS supports statewide recruitment and connection to organized dentistry. FQHCs serve as clinical training sites providing safety net experience. Expected Outcomes: Expected outcomes include expanded access and clinical capacity in Dental HPSAs, greater use of MIC and evidence-based preventive and early-intervention care, improved clinic efficiency and team-based care, strengthened workforce recruitment and retention, increased student exposure to FQHCs, stronger professional relationships between FQHCs and private practices, and improved patient experience. By reducing discomfort, lowering reliance on complex care, and helping dental teams reach patients earlier, MIC will allow participating FQHCs to serve more patients without relying solely on adding more dentists.
