The Delta Dental Foundation (DDF), a CMF corporate foundation member, is working to improve oral health access and care for individuals who have an intellectual or developmental disability. 

DDF is partnering with Federally Qualified Health Centers (FQHCs) to expand access to care for individuals with disabilities through their Centers of Excellence (COE) project. 

The project will soon be entering its pilot year involving FQHCs in Detroit, Ohio and Indiana.  

According to Holli Seabury, executive director of DDF, they have worked closely with FQHCs for many years due to their focus on improving access to dental care for those who are underserved. 

“In the past year we developed a focus on disability inclusion because the population with the most amount of health inequities is the population with disabilities,” Seabury said. 

Seabury explained that part of the reason individuals with disabilities can’t access care is due to the limited adult Medicaid benefit in Michigan. 

“There are fewer dentists who accept adult Medicaid, the reimbursement rates are low and it does not cover much restorative work,” Seabury said. 

According to Seabury, Michigan has a very robust children’s Medicaid dental program that covers most restorative procedures. 

“When an individual turns 21, there’s a term called ‘falling off the dental cliff.’ Medicaid benefits are greatly reduced and you’ll be unable to get a crown or root canal paid for by adult Medicaid in Michigan,” Seabury said. 

FQHCs are better equipped to treat individuals who have adult Medicaid due to the wraparound Medicaid payments FQHCs receive under the prospective payment system.

“FQHCs are getting higher payment for Medicaid dental which makes it feasible for them to see patients with disabilities because they’re not getting an incredibly low payment to do so,” Seabury said. “They also offer a sliding fee scale for procedures not covered by Medicaid.”

In addition to limited access to dental care, Seabury shared that there is also need for a highly trained dental workforce to provide care for individuals who have disabilities. 

“Until 2019, dental schools were not required to teach students about disability treatment, therefore we have many untrained hygienists, dentists and dental assistants,” Seabury said. 

Through the COE project, DDF is creating partnerships with FQHCs to deliver high-quality dental treatment to persons with disabilities.

According to Seabury, the project is working to systemically address all the barriers to treating individuals with disabilities, including training.  

Through their COE project, dental teams will be sent for immersive training at Penn Dental Care Center for Persons with Disabilities to learn disability treatments and behavioral techniques. After the training, dental staff will evaluate their clinic and determine the equipment needed to provide high-quality treatment. DDF will help provide support for needed equipment.

According to Seabury, while the immersive dental training is focused on patients with disabilities, the same techniques can be used with other patient populations with severe dental anxiety like those who have experienced trauma and those who have PTSD. 

Seabury shared that the other part of the project is to involve parents and caregivers in designing this system and ensure they are equipped to provide at-home oral care.

“We see a lot of caregivers, whether they’re staffed in group homes or taking care of a family member, they are really struggling to care for their family members if their family member is resistant, has any type of oral aversion or sensitivity,” Seabury said.

According to Seabury, DDF is developing educational online materials, sharing the latest research around disabilities and oral health and identifying systemic issues and addressing them. 

“We want to create a system of care and a place where anybody and everybody knows where they could go for care because right now, we don’t have that. Families, caregivers and anyone who works with individuals who have a disability, are struggling,” Seabury said.  

The hope is to expand the pilot, including an additional site in Northern Michigan where long wait times limit access to care.

“We’re working with the Michigan Primary Care Association to identify a clinic that’s either in Traverse City or the U.P. so we can have a clinic in our pilot year that will support that population,” Seabury said. 

Other goals of the project include: 

•    Decrease reliance on operating rooms and sedation to administer dental treatment.

•    Develop innovative practices and procedures to allow for integration of patients who have disabilities into clinic practice.    

•    Develop a turnkey model for disabilities treatment that can be implemented at any FQHC.

Seabury shared the only way to advance this work is through partnerships. 

“Until we really start to work with our nonprofit partners, who we have really close relationships with, and systematically address these large problems that we have in oral health, nothing is going to change,” Seabury said. “I’d love to be working with other foundations who work with caregivers, who work with persons with disabilities who work in healthcare.” 

Want more?

Learn more about the Delta Dental Foundation. 

Learn more about how philanthropy is working to advance disability inclusion.