Dental Reimbursement Program - The total reimbursed costs associated with the AIDS dental program were derived using the following methodology. A cost per visit was calculated using several sources of financial and utilization data: -The indirect cost rate of 10% was applied -The total number of dental visits for the period was 10,441. These data served as the basis for determining a cost per visit, as shown below: Direct Expenses Amount Per Visit Dental Staff $576,000 $55.17 Non-Dental Staff $1,026,216, $98.29 Supervision $257,465 $24.66 Fringe Benefits $679,899 $65.12 Program Expenses $337,669 $32.34 Indirect Expenses $287,725 $27.56 Total Costs $3,164,974 $303.13 Finally, total payments received was calculated as the sum of the the total payments received through all sources (Medicaid, Medicare, their public insurance, private insurance, and self-pay) for the period 7/24 - 6/25 ($238,022). Unreimbursed costs were calculated as the difference between total expenses and total payments received: Total Expenses: $3,712,440 Total Payments Received: $238,022 Unreimbursed Costs: $2,926,951 Dental services are delivered at the 3 Institute for Advanced Medicine (IAM) outpatient clinics, The Morningside Clinic at St. Luke’s Hospital , The Samuels Clinic at Roosevelt Hospital, The Jack Martin Clinic at Harlem. IAM serve HIV-infected persons in Midtown West, Upper West Side and Washington Heights- Inwood neighborhoods as well as Lower East Side of Manhattan who do not access routine HIV oral health care on a consistent basis or at all. The IAM offers a full range of oral health services and is complemented by an extensive community outreach program. The key program elements are: 1.Comprehensive oral health services to HIV-positive persons, including education and prevention services,targeting neighborhoods where there is high HIV seroprevalence 2.Outreach and marketing to providers, patients and the broader community 3.Community education and prevention services 4.Linkage to HIV primary care and psychosocial support services 5.Program evaluation and quality management There are several Ryan White recipient programs in NYC, but many do not offer the full continuum of collocated care available at the IAM, and few of them provide access to dental care. Ryan White recipients in the community include the Asian & Pacific Islander Coalition, serving the Asian Pacific Islander community, Callen Lorde Community Health Center, and Care for the Homeless and Project Renewal, targeting the homeless, and the William F. Ryan Community Health Center, the AIDS Service Center of New York, African Services Committee, and Harlem United. While most of these organizations offer access to primary care, some are limited in terms of capacity and breadth of services. The IAM maintains both formal and informal relationships with all of these organizations in order to ensure linkages to care across agencies and programs. IAM has a collaborative relationship with Mount Sinai Hospital dental residency program. The Director of Dentistry and her team provide continuing education to the post-doctoral residents. Training is offered on identifying and treating unique oral lesions specific to HIV-positive patients, and managing adverse side effects of ARVs in the oral cavity. Our relationship with our residency program is reciprocal: IAM dentists send patients to hospital residents that need complicated maxioilofacial surgical procedures. We also have a preceptorship program through the AIDS Education and Training Center in which practicing General Dentists receive on-site training to enhance their skills in working with HIV-positive individuals.
