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Dental Public Health Activities: Descriptive Summaries

Sustainability of an Oral Health Program

Practice Number: 37004
Submitted By: North Dakota Department of Health
Submission Date: October 2015
Last Reviewed: July 2018
Last Updated: July 2018
Best Practice Approach Example Sustainability of an Oral Health Program

When vital program funding from federal sources was reduced, it created a daunting challenge; how could core public oral health functions be performed and North Dakota’s oral health infrastructure be maintained without the expected resources? Since this was a sudden and unexpected loss in funding, it necessitated cuts in staffing and reductions in program services. To minimize the damage from budget reductions, the North Dakota Oral Health Program (OHP) employed two general strategies: 1) creating new staffing approaches for performing essential program functions; and 2) identifying and pursuing new funding sources and resources.

The primary asset that enabled survival during this period was a strong network of organizational relationships, partnership groups (the Oral Health Coalition (OHC)), and oral health resources that had been developed through years of collaborative work. This network was built by OHP in collaboration with a variety of partners including numerous state agencies, non-profit organizations, providers, funders, third-party payers, educational institutions, and communities.

Lessons Learned:

The partnerships and relationships that evolved over several years of collaborative work among oral health care professionals, the North Dakota Dental Association, the Long-Term Care Association, the Department of Public Instruction and others enabled leadership to draw upon this network of resources to sustain North Dakota’s oral health programs and vital infrastructure until additional resources could be procured. The trust and goodwill in this network fueled creative solutions, leveraging of staff positions, job sharing, and resource sharing that sustained operations during this difficult period. Additionally, the network enabled identification of new partners and funding to help sustain operations. The heightened collaboration during this period served to further strengthen and expand this network and positive working relationships, thus creating a stronger foundation for ND oral health programs. The OHP will definitely be prepared to share resources and positions as needed if funding issues were to arise in the future.

The reworking of activities and resources required OHP to dramatically redesign operations to retain minimal levels of operation. Some of the resource and job-sharing aided efficiency by helping to stretch budget dollars. However, the disruption in operations from budget shortages hampered operations by requiring more staff time to be spent on reorganizing workflow, adjusting staffing patterns (layoff/rehire), and searching for new revenue streams. This diverted some of the staff and resources needed to provide programs and services to OHP’s target populations.

Contact Person(s) for Inquiries:

Kimberlie Yineman, North Dakota Dental Director, North Dakota Department of Health, 600 East Boulevard Ave., Bismarck, ND 58501, Phone: 701-204-3438, Email:

Janna Pastir, Division Director, Health Promotions, North Dakota Department of Health, 600 E. Blvd. Ave., Bismarck, ND 58501, Phone: 701-328-2315, Email: