The Montana Head Start/State Collaboration and the Department of Public Health and Human Services (DPHHS), Oral Health Program are committed to support the continuing work of the Montana Dental Access Coalition to improve access to dental services for children. Resources to host a Head Start/Early Head Start (HS/EHS) Oral Health Forum became available through a $5,000 grant from the Association of State and Territorial Dental Directors (ASTDD) supported by the Health Resources and Services Administration (HRSA). The purpose of the forum was to solicit input from a multidisciplinary, multiorganizational group of stakeholders to develop an action plan to improve the HS/EHS oral health components, which includes enhancing prevention and oral health education as well as increasing access to oral health services.
Head Start representatives from different regions in Montana along with representatives from the Head Start/State Collaboration and DPHHS Oral Health Program made up the planning group for the forum. A facilitator with knowledge of oral health issues and experience in hosting community and statewide meetings surrounding oral health issues was contracted and included in the planning of the forum. Travel stipends were offered to invitees to encourage participation from HS/EHS and community partners.
HS/EHS directors, coordinators, parents, dental professional organizations, Indian Health Service, State Medicaid and CHIP staff, dentists, dental hygienists, dental assistants, and community health coordinators represented the majority of the nearly 60 attendees at the forum. Presentations on reducing Early Childhood Caries risk and decay transmission, Medicaid and CHIP program updates, partnering opportunities to improve children's oral health and an update on legislation impacting Head Start made up the morning portion of the meeting followed by discussion of current issues. Six workgroups were formed in the afternoon session to work on specific issues wherein each group was to offer possible actions or strategies to improve each issue. Workgroups were also asked to document strategies that may need legislative consideration. The workgroups discussed and prioritized recommendations in the following areas:
- High incidence of oral disease (including Early Childhood Caries/BBTD)
- Lack of current and accurate data on the oral health needs of the early childhood population
- Lack of access to oral health services
- Lack of public awareness about oral health
- Limited value placed on oral health versus other life/health issues
- Inability to locate a Medicaid/CHIP dental provider or lack of insurance or financial assistance
Forum participants used a voting method to provide a ranking of the small group recommendations. In the list below, redundant recommendations were combined. The top three recommendations are:
1. Facilitate collaboration and improve consistency among obstetricians, pediatricians and other doctors and dentists (e.g., education, prevention, costs of care)
2. Revise reimbursement process/provide incentives or bonus to practitioners that are willing to accept Medicaid patients
3. Make changes to the current Women, Infants and Children (WIC) Program to partner with Head Start to provide dental training and education as well as nutritional education to WIC parents. WIC participants would be encouraged to have regular dental exams and early prevention strategies would be implemented prior to age 3 when the child is eligible for Head Start
Outcomes of the Montana Head Start/Early Head Start Action Plan include:
- The Action Plan strategies have been incorporated into the Montana State Oral Health Plan.
- Montana Head Start Association members have identified which priorities they can implement in their programs and communities. Members will create short and long term plans for each program and for the Association.
- The Montana DPHHS Oral Health Program hosted a "train-the-trainer" session in December 2004 for Head Start staff and local partners to collect data on the oral health needs of Head Start children utilizing the Basic Screening Survey training instrument developed by ASTDD and CDC.
- With the follow-up funding of $2,500, oral health education materials were sent to each HS/EHS program for the 2005/2006 school year. The materials were sent directly to home visitors. A video entitled "Lift the Lip" was included so that home visitors and others can use the tape to educate parents. The oral health education materials were also sent to pediatricians, nurse practitioners and public health home visitors. Materials were packaged in an oral health bag designed by the Montana Head Start/State Collaboration.
- Oral Health activities and the Oral Health Action Plan are on every Montana Head Start Association agenda when they meet quarterly.
- Montana Head Start/State Collaboration is an active member of the Montana Oral Health Partnership.
- The Montana Head Start/State Collaboration has made oral health presentations to the Early Childhood Comprehensive Systems Planning Team, the Connecting for Kids Group, Montana Association for the Education of Young Children, Montana Early Childhood Advisory Council, and the Montana Child Care Association.
Mary Jane Standaert, Montana Head Start / State Collaboration, Cogswell Building, A-116, P.O. Box 202952, Helena, MT 59620, Phone: 460-444-0589, Fax: 460-444-2547, Email: firstname.lastname@example.org