Newsletter April 2019

Hello Idaho Oral Health Alliance members and oral health champions! With active support of members, sponsors, and partners, the IOHA serves as the catalyst for joint discussions and actions that lead us toward our vision of optimal oral health for Idahoans.

The IOHA mission is to: Lead collaborative efforts to bring optimal oral health to Idahoans through education, advocacy, and program development.


Big News: Oral Health Referral Network in Test Phase

We’ve been talking with you for two+ years about the IOHA initiative of leading efforts to integrate oral health into primary care settings across Idaho. Our focus has been on education/awareness with medical and dental colleagues and the invention of a statewide bi-directional medical-dental closed-loop referral system.

We are thrilled to announce that the IOHA Referral Network Test Phase kicked off on April 1 in a limited geographic area. We are working with a handful of medical and dental providers in Boise to test our processes, theories, and customer service model. We expect to spend the next 4 to 6 months slowly increasing the size of the test market, streamlining our processes, and collecting data and feedback so we can apply for grant funding to move to a much larger Pilot Phase in preparation for an eventual statewide rollout.

The unique and very important aspect of the IOHA Referral Network is that we are trying to wrap our arms around the needs of patients who do not have Medicaid Dental benefits. Managed Care North America (MCNA) is Idaho’s Medicaid Dental contractor, and we wholly support their efforts and will guide eligible patients to them, but the issue we are trying to address is how to connect other patients in need with dental providers. Conversely, we’re hearing from dentists who want to help their patients find medical homes—especially for patients with chronically high blood pressure and no primary care provider.

This is a very exciting time for the IOHA. Many states are addressing oral health integration, but no state is tackling the issue of building a managed formal referral system outside its Medicaid patient population. Our thanks to all our supporters and partners.


SHIP Sails into the Sunset

Since 2015, we’ve been reporting on our efforts to maintain an oral health presence within the Idaho Healthcare Coalition (IHC), Regional Collaboratives, and the Statewide Healthcare Innovation Plan (SHIP). The $40 million Center for Medicare and Medicaid Innovation grant was awarded in 2014 to reinvent how healthcare was delivered in Idaho. While oral health wasn’t included in the equation, thanks in large part to the efforts of IOHA Board Member Dr. John Kriz, we were allowed at the proverbial table. The SHIP grant work has now wrapped up, IHC oversight efforts have transitioned to a new advisory board model, several other entities are continuing to build on SHIP successes, and final reports are being issued.

In reviewing the Final State Level Evaluation SHIP report, we noted two significant observations:

  • of the 60 activities regularly tracked in monthly IHC reports, oral health was the 11th most frequently addressed topic

  • in a statewide end-of-project clinic evaluation survey, in terms of patient centered access and continuity of care, oral health integration was ranked (in aggregate) as a Top Three priority

These two data points are important because, through our SHIP efforts, we

  • kept oral health in the minds of our medical colleagues

  • had success in impressing upon the SHIP administrators the importance of oral health to whole health

  • found champions on the ground—in the clinics and in the health districts

  • were welcomed into the discussions about whole-person health for Idahoans

All of these in-roads are important because, while our IHC role has ended, our efforts to promote medical-dental collaboration and oral health integration continue through our collaborative efforts, our key initiative, and through the invention of our Referral Network. Read on for updates on our other current collaboration efforts.


Other Collaborative Efforts

The IOHA is participating in a collaborative addressing patients who present to emergency departments with dental pain. This Treasure Valley effort is jointly led by community health divisions from Saint Alphonsus and St. Luke’s hospital systems. We also have been invited to participate in the Blue Cross of Idaho Foundation’s Practice & Financial Redesign Initiative. This new collaborative is focused on several concepts that began during the recently completed Statewide Healthcare Initiative Plan (SHIP) including telemedicine, rural access to care, and financial reimbursement redesign.

We are seeing other avenues for tele-dentistry, medical-dental collaboration, and oral health integration open up for Idaho providers. Last year, the State Board of Dentistry made changes to the Rules of the Idaho State Board of Dentistry and Idaho’s Dental Practice Act to allow for tele-dental practice within the state and to clarify extended access settings and the role of a dental hygienist, especially those with a restorative endorsement, within these newly-defined settings.

Review the current Idaho’s Dental Practice Act or the Rules of the Idaho State Board of Dentistry and learn more about tele-dentistry or about how dental hygienists with extended access restorative endorsements can be utilized in Idaho.


 Advocacy Efforts

Medicaid Expansion Bill: At the very end of the 2019 Idaho Legislative Session, the Governor signed the Medicaid Expansion bill (with sideboards and restrictions) which provides health care coverage for over 60,000 Idahoans caught in the Medicaid Gap. The IOHA participated throughout this years-long effort in support of expansion. We will continue to advocate for efforts that optimize the health of Idahoans.

Medicaid Reimbursement Rates: The IOHA was a vocal supporter of efforts to increase the Dental Medicaid reimbursement rates. Due in large part to the work of the Idaho State Dental Association, the 2020 Idaho State Budget passed with the inclusion of a 10% increase as recommended by the Idaho Department of Health and Welfare Division of Medicaid. We will continue to advocate for decisions that increase the access to care for our most at-risk Idahoans.

Dental Therapist Law: Last year, the Coeur d’Alene Tribe unsuccessfully presented a bill to the legislature that intended to amend Idaho Code and create a dental health aid therapist position. This year, renewed efforts were successful in creating a new dental therapist provider level. Because the initial 2019 bill language seemed to have significant gaps in protection for patients, the IOHA board was not supportive of the effort. After several re-writes, Senate Bill 1129, as amended, was signed into law by Governor Little. As there are no provisions for this new provider level, the Idaho State Board of Dentistry is responsible for rule-making. The IOHA will continue, as appropriate, to advocate for the care and protection of all who live in the state.


Officer Elections

In early January 2019, officers were re-elected by the IOHA Board of Directors. Chair: Samantha Kenney, RDH-EA (United Way of Treasure Valley); Chair-elect: Troy Clovis, DMD (Benchmark Family Dentistry); Secretary: Linda Swanstrom, MBA (Idaho State Dental Association), and Treasurer: Graham Paterson (retired). Other board members include: Carolyn Brammer, RDH-EA (retired); Kathy Coumerilh (Idaho Primary Care Association); Susanne Jamison, RDH (Idaho Dental Hygienists’ Association); John Kriz, DDS (retired); Jack Lincks, DDS, MS (Periodontal Health Specialists of Idaho); Colleen Stephenson, RDH-ER, MS (Idaho State University Department of Dental Hygiene Sciences); and Andrea Timmerman (Willamette Dental Group.)


Resources for You

2017 Idaho Oral Health Environmental Assessment Report

In late 2018, the IOHA released the findings of the 2017 Environmental Assessment Report. The survey sought to collect perceptions of respondents on barriers, supportive entities, opportunities for collaboration, and issues that relate to access to care for Idahoans. View the report

NEW IOHP Website

The Idaho Oral Health Program (IOHP) within the Idaho Department of Health and Welfare has re-designed its website. Check it out at www.oralhealth.dhw.idaho.gov  From this link, you can find information about the Idaho Oral Health Network (IOHN), review surveillance data, and link to state and national resources.


Not yet an IOHA Member?

Join today by visiting idahooralhealth.org/membership and either download the application and send a check, or pay online. Anyone can join at any time of year, but you must be a current member by Oct. 31 in order to vote in annual board member elections.


Sponsor Thanks:

Our thanks to our Sustaining Partners, Delta Dental of Idaho and MCNA (Managed Care North America) and our continuing In-Kind Partner, Eide Bailly. These three stellar organizations continue to support our efforts in seeking optimal oral health for Idahoans.