
Meeting of the
Integration of Care Committee
Danielle Beiling and Donald Powell, Chairs
June 17th, 2020, 10:00AM -11:30AM
Zoom Video Call: https://zoom.us/j/4708943670
Members Present: Paul Carr, Mitchell Caponi, Dorothy Farley, Ronnie Fortunato, Janet Goldberg, Deborah Greene, Bill Gross, Christopher Joseph, David Klotz, John Schoepp, , Joel Zive, Rose Chestnut, Stephanie Serafino, Rob Walker
DOHMH/PHS Staff: Johanna Acosta, Guadalupe Dominguez Plummer, Ashley Azor, Eleonora Jimenez-Levi, Bettina Carroll
Welcome/Introductions w Pronouns/Moment of Silence/
Review of the Meeting Packet/Review of the Minutes:
Ms. Lawrence opened the meeting with introductions with pronouns and an icebreaker. Ms. Chestnut led the moment of silence. The minutes were accepted.
Public Comment/New Business
Line by Line Editing of the Oral Health Service Directive
Mr. Carr noted the importance of including oral HPV screenings.
The committee conducted a line-by-line reading/edit of the draft directive. Key highlights include:
- Use of PWH and not PLWH
- Program will use referrals to ensure access to other needs
- Inclusion of anti-racist service delivery
- Will require interpretation by the Department of Health
- Will require trainings
- Strongest language available for inclusion
- May need to name frameworks, ie Undoing Racism, to provide guidance
- Oral Health assessment will likely look different than the assessment for other service categories
- Some core elements, per HRSA, remain the same
- Is there an expectation of dentists to conduct intakes
- Someone will have to collect this data for enrollment
- Dentists already ask a whole health history to ensure safe treatment of a client
- Question of how to best screen for oral health issues and discomfort
- A validated tool
- Specific questions cannot be pulled from a validated tool, as tool is validated as a whole
- Questions should be appropriate and non-stigmatizing
- A validated tool
- Have never done a line item in a service directive – allocating a portion of funding to specialized services should be included in the service directive
- Not unheard of
- Must frame language to ensure that portion can be spent down in the case that specialty cases do not spend down the amount
- Even people with the best dental insurance have to pay out of pocket for implants
- If we provide implants, will we reduce capacity to provide basic dental care
- ADAP and Medicaid provide basic dental coverage – question of need for this funding through RWPA
- TriCounty uses their entire allocation each year
- Sometimes bone grafts and implants are needed to seat dentures – Medicaid is supposed to cover this, but haven’t seen much success in access
- Debate over amount of capped allocation for specialized care
- Co-located care management program is more effective than case management not located on site
- Idea is to build capacity across the portfolio
- Should the case management portion be included in the oral health care directive or be a part of another guiding document
- While a distinct service – this case management is specific to oral health care
- Pilot will be small. Question of how many programs will be launched
- Case management piece would work in partnership with current client case managers
- When a case manager conducts an assessment, it is a direct service. If a case manager does an assessment – should be a question of “last time saw a dentist” and provide referrals. Oral health case management may be limiting
- Case managers should be generalists by practice
- Word case management may be the issue – they aren’t true case managers – its capacity building
- Goal is to support integration of oral health care into system of care and build capacity among case managers to support clients’ oral health
- Necessary to emphasize technical assistance
- Case management envisioned as a DOHMH staff person or consultant
- Service does not necessarily need to exist indefinitely – needed until integration is complete.
Public Comment
None.