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SPECIAL PROJECT OF NATIONAL SIGNIFICANCE TENDERLOIN HEATH & - - PowerPoint PPT Presentation
SPECIAL PROJECT OF NATIONAL SIGNIFICANCE TENDERLOIN HEATH & - - PowerPoint PPT Presentation
SPECIAL PROJECT OF NATIONAL SIGNIFICANCE TENDERLOIN HEATH & SFDPH ORAL HEALTH INITIATIVE Avantika Nath, DDS PRESENTATION OVERVIEW Introduction Background Specific Program Objectives Barriers to Care Challenges Clinical Methodology
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INTRODUCTION
2006 - Health Resources and Services Administration (HRSA) funded 15 demonstration programs nationally to increase access to oral health care for persons living with HIV
Tenderloin Health (TLH) was one of these sites and partnered with the SFDH for this project (TLH/SFDPH)
The Health and Disability Working Group at the Boston University School of Public Health served as the National Technical Assistance and Evaluation Center
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BACKGROUND
Oral Health Care (OHC) is one of the top unmet medical needs in patients with HIV Improving access to OHC significantly improves health
- utcomes
Engagement and retention in OHC leads to improved health-related Quality of Life Exploring innovations in OHC delivery will allow identification of the most efficient models
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OBJECTIVES
SPNS Objective “Increase access to OHC for People Living with HIV and AIDS (PLWH/A)” TLH/SDPH Objective Provide improved access to the Homeless PLWH/A within the Tenderloin District
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BARRIERS TO CARE
Structural
No dental clinic in the TLH district
Financial
Patient either lack or are unaware of medical coverage
Individual
Discrimination due to HIV/AIDS, LGBT Language and educational limitations LGBT
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SPECIFIC CHALLENGES
Homeless patients are difficult to track since they move constantly Organizational instability at TLH Staff turnover Statewide MediCal/DentiCal cuts
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CLINICAL METHOds - issues & SOLUTIONS
Target population
Triple Diagnosed
Integration with primary care and medical case management Co-location with Medical services
Unstably housed
Dental Case Manager
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CLINICAL METHODs - custom approach
Multi-site Evaluation
Eligibility criteria Baseline enrollment Patient surveys Utilization data Final data collection
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CLINICAL METHODs - collaboration
Partners & Linkages to Care
Integration with Primary Care at SFDPH-Ward 86 at SFGH
Referrals agencies
Asian Pacific Islander and Wellness Center Larkin Street Youth Services Rehab Centers (Walden House,Ferguson Place)
Community-Based Dental Partnership with UCSF for speciality services
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RESULTS - significant changes
Good practices - improvement
Brushing Flossing
Bad practices - reduction
Smoking Candy consumption Soda Consumption Outcome Baselin e 12 Months Unmet need for OHC
48% 17%
Good Health of Teeth & Gums
38% 67%
Oral Health Symptoms (Mean)
3.35 1.78
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RESULTS - CLINICAL
TLH
Dental “HOME” established
Established a LOCAL two-operatory dental clinic
450 of ~1500 HIV patients residing in the Tenderloin now being served by the dental clinic Speciality training provided to ALL staff to improve cultural sensitivity, especially towards LGBT
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RESULTS - CLINICAL
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RESULTS - CLINICAL
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FUTURE PLANS
SPNS officially ends 31st August 2011
Demonstration project No further funding Sustainability plan ~ half of the current SPNS sites
- A. Nath successfully applied for Ryan White Part A funds
SFDPH will continue to partner with TLH
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ACKNOWLEDGEMENTS
TLH Staff SFDPH Dental Services Team Leaders
- D. Fernandez
- M. Ogbu
- B. Garcia