Summary report - National Maternal and Child Oral Health Resource

B.l5
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1994
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TA?ERlIAL
AT{D GHILD
ORAL HEALIH
RECtOItAL
WORK9HOPA
SUMMARY REPORT
JaneE. M. Steffensen
R.D.H.,
M.P.H.,
C.H.E.S.
l|teFrr.d !t
Mrtemal6odChlldHeallhBuresu
HeallhResourcesand Servlco6Admhtsustion
Publlctl€alth Service
U.S.Dop€nm€otot Heaitr snd HumanSeflices
hallrld
bt
NatiooalC€oterfor Educauonin MalematandChitdH€6tth
Arllr€ton,viEinia
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C ON T E N T S
1 .
\ l\
r. \\ ].| :. ].
ll'r
l. Introduclion
\l.n Lr 11
\\
I r ,i\
t i \ r r ' I . r l! \ , r r
i
2. RaElional Workshop.
r ) ' , f . t , r , r l ,r' | r
I
jr r I r . Lr,i T i r(r.r,.
3. Outcon€.
\
ol ReSlional Wo*chop6
..,\".
r t::
..
l
4. Future Opportunltie6 rnd Chattenlles
.,
f
fr,
!::
r.l
.:.
'l ,
.'
,t:
5. App€ndicsi
::
1:''
il
rr
"l
:
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r:
i
l.r '1.r,''
I
rr ' :-.'
t,tl ,
G0 3 P OX 3 0 n 3
R E OtOl tl L
0F
WORX.tltOPS
Il|e folk ingoational
o4anizalio6.nda8.rri6 coqoGoftd
fu fe$md k ldntc
CapPolicy
A8enct
fo.Health
.rd Resenlh,
U.Shblic fle.llhServb
AnErirn,Ladeqd RdirtL lkntisty
ftrFrlcan,t a&mydPedirfics
kn€dcan
Asociation
ofDrntzlS.hools
A[Erican
,tsocirrioo
ofPublkllealhD€ntisuy
AnrdcaoCHIPalab-Cmiofuial,tsociarion
Msican Dental
bcialim
,tm€dcao
DeodHninilb' f,$ocialion
Nuses',tssoairlion
AnEricao
tuftdcrnPublicHealfi,lssoclelon
fssociation
dconmunityDtllhlPDgrrr6
,ts$o.jedon
ofMaErnal
dd ChildtlealhProetr,I$
,isocialion
ofsut andltnihrt l D6 .l Dindors
,qscociation
ofSldrad ltrdhiid lle.lh otrdrb
Chi{ Dental
ofr.ei U.S.Publtc
tk lh Seflhe
Idian tle.lft Seiyice,
DentalServices
Bftnch
Medlcaid
Bwau,Health
Cafttinancing
Mninistntion
ofCornmunily
CmEls
National
Asociaiion
Heallh
d SeialWo*es
Naional,tsociation
Nrtiqul lsociatin d WICDi|tdo6
for[ri..edd| in M&nrl nd chi! Ileelth
NatiotulCenEr
Nrlionrllrditib d ftolxl Rr...rdr,NaliondLKituB oalk lh
a numbaof oqanizaliors
ard agmcies
suppoi€d
rofttDp
In addltlon
lo coeonsofi,
elMtb, hoitedseisiorE,
ardolhbor.bdvi$ tE Publbtleallhbvice Regimd0fi.6.
Inchdedsub ard localhadneob of lpallh ard
Cooledinggffirtrffi ageodes
human
servic(!.
fl)
I
TRODUGTIOII
fssue Statetnent
Pretenrlbleorel dite66 still aflid d nujo?ity of cl,l!1ftn, fouk,
and hbh famili$ and l)armb in our tation. n6e condilioltstxcur
dqtle gul deLektnab atulalryo uniliq in hnotledge.t$hnohgl
4nd ded EftaenthE metkA.
byl, ad /cc6. 1990
Tfu lackofequitable
access
andunircNalavailabilihof dlerccenladvanc€s
in oralheal l
tr6
d
harcbeenoullinedin manynationalrep0l6,nd niteratedat tlle Matemei,nd Child
tl€althRegional
WorkshoFIn addition,cudEodlavailable
oralhealthmeasuGalt not
3r utilized,eitherbypmiesionals
ormnsurnen.
Background
D6rlopments
dudngthelale1980s
endearlyl99ft hayehada significanl
impacton
H
pmgalns
ardhumanseNice
thalafre€1tle
orri h€althofchildMlandfamili€sSoneof
maiordevelopments
inclDde
l.hePublicllerlth Service
Wod$hop
ontheoral Healthof
-*5
(Seplemhr
ardChildren
1989),
implernentalion
ofamendnents
tothelltle VMalemal
J OUUHealtb
Serdces
Programs
ardlitle ){x trftdicaid
statutrs
fmmfie omnibus
Budget
lft
iaionkt of 1989(oBRA89),courtruLinp5
onareaslo oralhEddrcareforMedicajd
Lt of
ncipi€nb,
fderallyQudiH He.l$ Cf €rsuder he OnnibusBudget
Recoocilialion
1990(oBRA'90),
ardBriShll'u ns ChiHUe4Ih${€NisionCui&lin6.
In addilion,
a number
of rEors d ndionalsignficrnahat€btenpublislFd,
inclding
theRqod of Cbilakenb
DenlalSeflrc$Underbe |tldi.4rr'eofran (ofiiced T€chnolog/
llf{5NIrpt\; hnttooinglh OtulHalh 4 freAnwkn tU*
tudr ol dal Halb Mn i6 of be lrydne
qpodunitffu ,Aion: A
{ ,lqllb and lturnanknti6; HaW
People
20M: ilarioial Healhhomotkn and Ditease
katenriofl objeclit6; Healtb!
hn
anilb 2000;bal elb 20N: artcarleb drtrkzlPraenic Sei,i$.
Aoenleut of tbe NottonalVorksbop
ad
0n hErnier 10-12,lg9, a gmupof 125nrlionly rc.ogniadhealthprc{esionab
adrcaksrnetto addrcslheoralheallhnee&of motll€ts
andchild€nifl tlE United
corEunpr
Slats. Panicipanb
al thisnational
xDrkhopformulalda sedoo{orrl kallh ccorunendaesrell xslocd,
tiorufor publicandprirrlehealtho8anizatiors.
agmcies,
rrd ir6ti0.rtiora
$ale,ad fodaalBownunens.
,&rl(shop
pmvid€d
TE natiooal
apf,ofirnjtj€s
toi
. !618 alqrdononis$€safieding
maternal
arddrildorulhealth;
. Elicitexpen
opiooioos
poliq,ad consuner
afais,
tom invitdpdtkipanbin science,
onm€chrnisns
foroplimlzing
d|eonl hexlhd chiftm andtuolfi€rc
. Deidop
asetofsnbgiesh o€€tftis challenge
. StimulaE
inhE t andircrEassuplonof oBanizations
flat canhaw
a'|dindividuals
iinpdt
o.al
an
ondecbions
ardo?ponunities
in magiul ardchild heallh;
ad
. D,iseninab
tlE lor|(shop
ltponh agenci€s,
organizaliols,
tlealthandhumn seryta
prwide6,
adrDinifabn,ardtr public.
Workhol ftomrne0dations
lrele &lrloFd follo\ring$'alurlion of comm(sioned
ba(k
gmundisuc pErrs. oral pltscntxlioffb! plena ecelars.(bnlificalionandpriorilizatjonol
Jr\trsr issu€5aff€clingrnatemalandchild oml hedlh. and$rateg\co[*mus advam(db\
:nknsi\r dis{rN\io|tiessions.
l)r nudrs liar eri Depun{siJtant Secrlrlxnfor Hedlh.Itarird
XL.eKommendafions
on hhtlf of thc PublicHeahhSe^iceduaingdlc fhtal plcne s6sn)n
nr *ofuhop epon ,nd ba.kgrcundisue p4qs ar a\"ilabledr puhlishddocunl€nti.)
ll dr nxtionxl{rrlihop. {ork gmDFi&nifie{ nrultlle $ralcgiea
l0 aahie\rea.hmomtrrhton
TheNommendattons
outll edx?rt dirrrse,aJ no induidualagenclororyiJrir!:t-
tn (nuld $complishlhen aloneieachoryaniiationne€ded
lo i&nlih fl€ [rotunmdatiotN
d.leirh
applicalb
lo iL\osnnision.
Ttrenxtionalworkshop
outlind 139rc.ommendations.
heft grouped
in thelolloving
h.:ts*on6
: ImprortpubliceducetioD
inlen€ntions
to incnasekno$ledge
endirnprctrattitudct
3lnulorildjealeprclention
andoralheillhpnmotion.
I l:\pandpn)fessionaleducali0n
xndpromotion
efforbto increase
kno$ledg€
and
nTm\r \krlh andnttit dei ah)utorxl diser€ Felentionandori hei th prcmoljon
rllxrn8prcridc6.ddminirtrat)n.J)oliomaiiers.
xndconsumer
adrccatBol healft and
hummstnicl]i,
i lrselop coalilionsto adr'ocaE
lor xrd collrLborate
on oral di$Nr prc\'enli0nandoral
iEirh lromolioni$u6.
r lanng$rn sulpod for oml heahhplio in the healthandhunrn saNiccqslem al
::r!llxlrl. slrtr. turdlocallc\'elsbt'marmizing adninistr. ionof citallishedpolio rnd
qul onsalrdderelopingne$
lcgislatjon
turdepropdatio$.
< \4gon cmrdnlleddalacolleclioo,
eraluation,
andresearch
eflortsto :rssess
oral
idth !l3nN.irh3\ i(,ml :mdp$rhosocialfa.tors,oraldiseie prer€nthrnethods,pro
!!..n oi oml hrdth \€Nices.xndFDgranoFr.ttions.
REGI O l { A L
W O R K S HOPS
Du.ing1991,thePublicHealdrServic€
Regional
0fiicesheldelen egional\$rl$hops1o
lhelxrlen'
srrrgdrn $e procssol achielingthenationalacommendadons
& to maj{imi7e
iromlhepub
tsl oaothermaiord€rdopmenlr.The\rDrlchols$rrudsignedto lrovidcpeNons
inmsled in heahhandhumansenicrsqith theopportuniti
. l'!l priyate$alor oryanizations
D l.rtlop collal$ntiw stralrgi€s
ard e.lionplemto addrssorrl hcalthisuesat stahandlocal
Ttr *or{shop embraced
thephilo.iophv
thatoralhealthis a vitalcomNnentof health
ItN
d dlness for childrenrd theirfrmili€s. 1h€seworkhop6wcrefundrdbr &e Matemalard
(X
lleah\ Bureau,HeallhResourcei
ard seNiceiAdministrution,
PublicHei d S€nice,US.
of HealthandHummSeoices.
lltrt'll
]1p frlsl sectionol his reponsummirrizes
the oryanizalionelaspec$of lhe Regional
lErul
b
i,1dChild0r. Hcallh\tbd6hops;the$condrction provides
a q,nopsis
of outcomes
ft *ofuhoF FutuFa{tlonsard oppotunltiesfor addressing
fanih oril heahhissu€s
lCtthEd in lhefinxl chapter
-
ovERvtEw A]{DORGAl{tZATtOl{
tlte pu.lce d fie Regional
VodshoFef,stocoNrn€grouFd inviEdpafikipanb
with
qEcidery€nise
l'' EcomrDend
$aregies
lo addrtSissues
?feclingtlteorrl healthof tllechil
drtnandfamili€s
withinPublicHedlhService
Ggions.IhesotkhoFpmvkled
anopponunity
forpanicipanb
lo gainhoxldge eloutdEis!€sthalinfluence
healh
oral
andfu inEn€le'
liordripbmitt r d|ecisslasard od|erfraebof thel|eal$,nd hwnanreMa qdan. In d s
say,tr cDlhhoFalloNdprnicipanb
vith ditrFeba.koundslo.ollaboaLin ro* gouts
andlofoct6allention
onomlhealthissues
ofchildrcn
andfrmiliesbydcrtloping
aaionplars.
panicipans
Prio.to lh€Regonal
Wod6lDF,
rccenEd
backSmund
materiab
fiat provid€d
panicipanb
anoErview
of rcaent
dfreloFlslsin maEmal
anddfh onl healthendprqerEd
for[r plenarlsessirxr
anduo* grurpdisclsiom.WorkgouF rcrem4rsedtr)fomulare
suategi€s
forinEgrzling
ndr legidaliwpovisions
ard polic1initialirGi o etion plans.In
priorities,
li$t of difiercnt
rcSional
alematitE
oryani?arional
appnruhes
wn &wl@ ed
wrbhopschcenoth produoe
irdividualstabaation
plrJE.Alone$oal6hop
sorne
iftolving
lhrEePublicll€dh & ks rgio(E,pafticipanb
€$rblislEd
drionplarsforetlltles diftctd at
tr narional,
state,ard lo(alle\Els.AnotErxorklrcp@rnbining
tro hblic Heal$Senice
egionsddltlsedadicecl a a Secificisue,ald eaahslat€\ro* $oupdelrlod adocaal
skillsardformulal€d
asul€adrcca.'plur
Pafticipanb
invitsdh lheRegioMl
VofuhS ilrludd officiahpolitlmakm,goftsionds,rdrDinisFaloE
ard adilcrB qmenting diwsetralh andhunansediceagenci€s
aod
penichans
oqrnizlioN. TEre
{El€ent€d
th@shoplan.manage,
fts€ardr,
ducab,deliEr,
consun€,
rnd payforhexlthandsocials€rviqr.Alsoaneoding
uc|t individuals
mftin8 in
pubuc,
privab,
in
fu
nonpDlit
rglunary
and
,nd
seclors.
8o\€mmert
GOAIS
N atlonal Plannlng Commlttee
In 1990,
r Nalional
Planning
Commifiee
formulaled
amison slllm tharserwdasth€
bcisfordr Matemal
andChildOd tterlh Regional
votul|oF;
Inoqte aaiaral$ andimlrmEinlegalknoIofll fukb in llteprinary czreqst,tt,
andlrmat EfuU,i la@tl*trxfot nolMs andcbildo. htdudingfu)s.bil*e, anb
Wtl bulb nek.
Ttc folloxinggoals*tre alsoidentified:
. llerrlopcoalilionr
to adlocxkfor lx)licie6
to improrctheorrl he:dthof molheFand
chiklmn
. lncci!\eevarenrlsol oi.tl healh issues
ru $e prccc\sof inrplementing( l ) 0BR{ u9
Scnrni4. Dixgnoslic
lnnisionslhatchrngeaslertrof the\laiicald tarF andPeriodic
(EPSD1)
snd freatmenl
prognmandlille \ trlal€mal
andChildHealrh
Scnice
(,1)Healtllr
Prrgrarns:
Prlplel{no: NationalHeelth
Prcntorion
andDi€|rse
Pn\rntion
obiecti\6:md (ll thelKomnrcndalions
0f $c PublicHealth
SeniftUb*thol on hr
(hlllulih ofllothenand(:hildren.
. FonnLalea hdne$orkfor a slatc:LclionJ)l:lnlo orrt dtc0ru1healthnet(lsol motheA
iu childen$ rflttld b\'thele8rsldne
equiremmc
of08R{ 89
. IncBx\epublicmd prirat collalnralionto rmloit hanie$b oml hcalthcar at $e
Reglonal Plannlng Conmitte es
krxLsiortheRegiontlUbrkhrp
*tre :Ldaptcd
br egion.rllhnningconnninees
ba*l on
md n€eds.Thefoll(ruinggoalsurruadapled
lo r€llectimponxnr
ltgtonal.
tEr. pnontles
a- r,1dl(Xdconcen$
andeqerienqj
L.da Araaaa|llaot
16k{| r)rrlheahh
stin-Ls
ofchildrcn
endfrnihesin therqlrin.
Co.lltlo€, rrd Collior.doi
^avoc.cy,
i:r_rsatell(t\r adm{xclfororulhexl$ISu63tthestak.nd lffai leYel
Phfixrre
publicandp valepr nerhiJ)s
rhrough
delelopment
of int€fuis.iplinaN
corLinhr lublicandln\rlescclo6
in tocusing
onorxlheahh
isueih\ conruing
a ntulti
.]lsolhnrnBmup
ofintcc$€d
panicipants
L.aaa to taarlca.
::::ln,r(the $lllxbilil\ of orrl healthser\'iccs
for children
rnd lantlies
.:r--Er.tr.essl0orxlheirlths€ iceiunder
tht trl€dictid
progrum
L*t
:6ti {' r \ulele8lslxti\€
agenda
lopmmole
ofii hee]lh
ft)rchildltn
|rltdIamili€s.
,,:(5r!r th€con*quencs
o[ ecel]lcounaations
conc€ming
rcesstoordhealtb
wnrcs
i( \kfuilrd re(rflenr
Er61nr
thalonl healhseftices
aleaninEgralcoreon€nt
ofth€Iotalhealthcarcslsten.
I&ntl! penorurel,
r€sounes,
andmetho&dratartcritir:al
forimplem€nlrng
thesanegi€s
da€loped
atth€ngonalvo.khop.
h !5d$ Praaro0oard ELca||qr
Inmas€howledge
of oralhealthiswesafiecting
dr nee&of lol iDcoIEchihrmari
fanili€s.andDetlom
withso€cial
ttealhn€eG.
AGENDASAND THEilIES
plenary
ItesetxoiE Regional
Vo*sho{6usualyconbined
a ketnote
pEs€nlation,
invitqD* group
edpl€nary
sessions,
s€$ionE
andinendlor$durinSsocial
a.liviti€s.Gene.alh
tlE
goaloftre agerda o pro\i&informarion
inflr.pn
e
oral
lEdlh
onecentdernlopments
fial
i$es in staEand""s
localmunicipalitb.Padiciprnb
alsok JrEd,boutormntpIlgruIs thal
d€direl,vaddttss
tlE oralhealthned ofchildnnandfunilies In thjs*ay,panicipana
had
opportuniries
lo shartFog?mrDaric
ide6f'ornsats bth vithinad ouSi&frn rcgion.
producliye
andpo{itiiroutSnallgoupsessions,
orwort grouF,generatld
ewecially
com€iIlEa€s€5sloN
alloi,.€d
nErnhntoassess
tlEfir€ poinbof$€cificpriorityissu€s
Sroup
andto wodrtogether
in developing
problems.
In several
aationplansto lsltle identified
insunces,
tlE Regional
VorlshoFprovid€d
glup
theftst o?potunitv
fora multidisciplinary
toeorl togetl|er
inbnsi\rlytoelmiuah
mrnvissues
afiecling
orallEelth,to studrlh€a.crmplishmes andshonmminsof de states,
andto formulate
for impmv€ment.
skategi€s
Specific
t sl(sre't esigned
toeaaim sesion,dd cDrkgroulE,&lE
expeald
toa.complish
,rod(gmuphadafe.ilgoals
goupcons€rbus
d€fined
bydercloping
duringdTs€siorls.Eech
panicipanb
ilatorphoencou.rg€d
lo di{1ls a[ isu€so0.nly'Using
0is approa.h,
the{e.ilic
goalsof eaah$Dfthopdetermin€d
fie tAicspft.entdin tle plmarysesions
c rcll asthe
timezllorred
forno* goups€ssions.
lte Regional
wodshoFaddftsed
dlefoloxinglopi.s
plenary
in
sessions.
fbada Aa-aatr-rt
MetM fo.0raltl€alhNee&A$€ssn€nt
Sp€cial
Populatiorb
eithUnrEt0rrl lkald Nee&,
including:
Persol|s
wiltrAecielttealthn€&
populations
Minority
ftlschmlp.pulations
ExDectatt
rndrc\r'DarEnB
l.r!G..'{rl{iaOteortn|0..
RoleofMvcaaLs
wih Partne$
Collahoration
in PublicandPfh"lePaltE6hip6
lnbrgemmtonal
adm(za'y
tl€xlhprofesiond
sociatioN
D6Eloping
skills
pmce$a5,
MrMl ty!a5,
ardnrdto&
,idtMlr PlenFrllns*ork
hgislrrirr&{egb
,tdninifatiw Slr"l48i€s
ld^t|.|cLfffi
Acc.- d larrrch.
VanProSrans
t&bileDental
HoqitxlBased
PmSErns
SdtmlBnd Ptograrns
tleadStartPDSrarDs
(fe&ml,st4t€,
Coonunily-8as€d
tlealhCenEls
aIIdlocd)
krdrr PafnenlSFtsn
tdnih andOfld lhal6 ProglrlN
Saae
Ddal ,fs$ocirlion
$oisocdhogrrDs
tdffimt
ftr tardc-
I-Hnaf.-src.a
-d
lnEfl€tatior6(fd€ni andSlatePe|Eedirt)
ofoBM'89PrflistorsTial ChanSe
AT€.1s
of lhe Medicaid
EPSDT
PmSram
andlhe'litl€ V MatemalandChildHeilthSe ic€
Pro€fanrs
Repon
of ChlldrcntDentalSen'icrs
underdrcMedicaid
Program,
ofiiceof Technologl/
lsrssmmt
knlly QudmdllealdrC€nE$(fmm08RA'90
plwisiofls)
li€elhyPeople
2000:National
tlealthPrcnotion
andDis€ase
P€rention
Obj€dftsand
HaW Contnunilb20(n
necornrrdaiomof de PublictlealhS€Nice
worklrcoon tlleoral l+althof Mo{Ers
{d Chilftn
B.idt FUOrIS
ChiUlkalthSuFrrisbnCuid€lirE
(Chrkrs.
Cou.tRulio8sonAccess
to oral HeallhCarefor Medicaid
Recipients
lczer-{alifornia)
DenulPlovider
Peq€cliksrndR€+orEes
Concsming
PoliqDftlopmenb
Edoc.dolFco|r||
Oral tbd$ FroiFdor
-at
(including
loohd€cay)
bal,vbotd€
TmthDecay
fluoridalion
wabr
ard
ommunily
fluorides
Denhlsealzrh
pm.tic€s
fe€ding
AppmpnaE
0.J Cancer
andc€ssetion
Tobxcco
use-+evention
0ralInjuri€s
Moulhguads
andlollow-up
&rening,Referral,
t0
nlty rd ldM
d
OUIGOTES OF
REGIOl{AL WORI(EHOP3
propos€d
ln as€ssment
of thest.ategi€s
al the
indicalas
e numbcr
of rimilari"orkhoF
ts .rnongther€gioos.
ReInsfmm*le Regional
Ubrlshqrjou inedsmegi€s
to maximize
E0t6
lorprL1mtiw,
educational,
ardther4)eulic
sedices
1oleaahpemnsllith tlE highesl
zndgt?atest
unnetorrl heallhn€c&.In addition,
budgela4
consFaints
andEgulatoN
havercsulled
futes
in denands
for incr€ased
coodinalionof loaal.state.a
national
to plan,irnplement.
,nd evaluate
healthandhunanservices,
includingoiel healttl
-at
tE.
h
ToensuFco inu€dptugrssin oril lEalth.stral€gtes
v€trsugtFtdtointegnFcmF
ardefiectr orrl halth measuEs
witiin fami\'ccnEnd,
comrnunity-basd
}l€althlRl"
arddisea*prwl(oo seniqiaswll a5within[|e Erapeutic
seffice
s.!sLm.
-
lhi srrtionof therqnn pmvideasumnrary
o[theoutomes
of th€Regional
Workhots'
A(page
uotuhq)s
hidli$s oflh€individual
4) coorairu
COMilOT{STRATEGIES
sErci&ntiffd bylhe40m* gmupattllesercnRegional
wotlBhotr.
Multiple
slral€gies
Folloving
zr€lhemmmon
sfaleSifs
thalenergdfton dxsevofuhoF.
taaadaAsaaaanani
Prsdazl,@orM,
and tunfudizd nat as,s''natbfuaU beplannd ann
inflena{d at stahand locallzLekh evaluate,
4xn' and monilorfaais fut
inlh/ence
6d bu b ona @ntinuing
fueis.
ar€rrded toases:
Praatical
ardcloldinal€d
daracollection,
evaluation,
urdcsearch
1.Contdbuting
fa.lotsassciabd
wilhpovi&Fandcli.fs, incldingducation,income,
occupelion,
knovledge,
eltitudes,
beheviols,
riskfadon,acce.s,
use,anddenad for
se icesi
2.Oralhealhslan6rndunn€tn€eds
ard
prwisionandFogranplannin&
financing,
s€rvice
3.SFtnrse luationinclldingpolic?,
implemealion,utilizalion,
andFogramoperalions.
Advaaaat, Coatrdona,Coll-oradoi
statsl*fuanlit rn nd ta befu&M b adh6 otal bulb a$r?{' I te gettt
@lbbfition b Nnlial etrrng fuEklment b plan, ln$letnen
and crljss-s)Jsten
andauhuteFlic*, savica,andpmgsrrn.
corlitioNtlnt indud€planning,
n€lsoddng,
andducalionn€edto h &rtlq€d at stale
vouldinclu&:
ardlocalle\tls.TtEs€
l. AninEngencl
conrnitteMthinSormment
forcooidinelion,
int€gmrion,
andcollabo
ration:and
2-Apublic-privare
malitionoutside
thegove l|entectorforadrocaq,
collabonrioq
and
gla$roosnetrolng.
lcc.../Polkt
R{odnsae neld in kallt andhon4nsen*z st"lenpolk:iab prouideuniaaxal
a.c6 topihtarf otulh@llhaae andprao *,emus6fot cbilhenanZafuth.
E[6tite nelxx^ oe neld k reruil and retainfiintsry fulh carepaibt b
fuliwr oralherlfrseroic*in unbrsend @ntmunitb.
12
of r Uedicaid
IPSDT
and
Relorms
ae paniculfi]!crucidin he Om.lHealftCoryonenl
Poliochanges
should
lhefollo\ring
taati(l:
trieilicard
aduhprograrns
combine
I lncrcllea{aess
tosenic€s
forclnidren
rndadulbl
I Increa\e
reimbuNem€nt
nteaandfa schedules;
prolidets
of seNice
through
strategies
lo r€cruilandatainddi.
i. lncrcarthenumber
tional&nnl pro\id€rs:
and
{. str€ernline
andsinplifibillingandFi1nenlclii proc€ssr5i
simplifi
pmcedulls.
Reducs
bariers
to
enrollment
and
applicanon
5.
Pollct/nn'|cl|r.
PoliLlt4onnsarc t@tld to ndaBe th focuto otul helh a\\u6a !1b inlegale
eftlft e ordl fuollbconqnotb u*hi lritcl deteloPno. ith Wial lnorih Jor
rdlrrce alltuttio lrnra\6 dt ln sl4katullocalla ds.
(2)
polici€s
str0glhen
rnlhehealhandhuman
seflictTstemto (1)finaicesedices.
julJ)onderelopm€nt
(3)
of humanrtlources,
irnd provide
xcftrslo coordinaled
and
s€Nices
andlocallerls
lhrcugh
con)lBherNile
alslate
thefollo$in8:
polio:
I ll.L\inizinSadrninistration
of€stalhshcd
guidelifts.
I Including
orrl h€aldlpm\isions
in regulations.
andstandardsl
and
i l)t\rlopingne\r'legislatjoq
1 {lb.atngalTmldations
andftsourc€s
H Haalti ?ro o(dr rd E.hcldoo
t4\1nd ud inprurc eJIeclie.coadinaledpronotiondnd cducationelfo/lsk)
,\i\Lre b auled1c
and impraletltludK atd shilknt lret\nh g onl dtseav.pm.u)lt,lRo l lrealtb.
a,klpro&lng llp/.4,eulu:
funhl sm i&t Promolrinattdeltut
,'t eforttrlnulll&Ih6 balbll,epuAicntvlpmJ6\'bulsectot.
publicducetroninteenlionsr
I Publrnlucrtioninitdi\6 should
enhence
endlncta-\e
(l)
(l) latienl
iinxl€dge
i{ilhin lhepublic
a inrFowaftitud{i
andlheconmuni$.
rllrratlt) . and(3)s.hmlhealthpmgrinls.
education
lc)
: Pmtessronsl
d€r'elopn€nt
andeducalion
iiten€ntions
should
€xpand
i:Trut krorledge.
of hsJ$
skrlls,
anddtiNd6of (l) provideA
arrdadminisldtors
I..|l humrnsc ic!s.1l) ducno6.(J) poliom*e$.publicofficrds.
xndlxl*maliels.
ofhealthandhumarsenicn.
rrl rr r corxumer
rdlrxates
1.1
succEssEsAt{DsHoRTcoiltlrlcs
OUTLINEDBY WORKGROUPS
oml lEalthprogfiuns $ateandkrd levels
thmughoul
thecountnh r eiol\t(ldiffcr
ona combinatiur
enlll depending
oi politicrl,hhloricxl,
soaial.
enyirunfir0tal,
econoic, and
lisaalfor.es.Tter(fa.brshaleinflucncrilhepmgrrrraccomdislurm$
e\$riLf,sfle setbaah
occuftdlithin slxt€s
summarizrs
thesrc@s6andshondlalhave
o\tt the]l:rjs. Thiss€ction
$brkhots.
cominFofonl healthtmgresi&ntifid b\ tlE$DrtgmuFalth€Rcgional
Szccesses
pmyide
Hcdthandhununseniepmgrrms
at stattandlocalleveLs
ard,/orfinanccprimrn care.pftrentjon.
oreducrtional
s€Nicei
lor theor.rlhealthof childenandadults.
The*pmg|lmsintraclEjthdir€r* oqanizaliotu
rndgmuFin theprirrle.lublic.andnon
prolit*rtos
pmgram
lle following
li$ingoutlineisome
ofdrecomnnn
componcnls
identiiied
a\suc
c€ssfill
b\ lhctro* grouF.sone$ateihrd ounr conFnenlsin plr.e:oth€Nhadonhr fe\r
functioning
atfie $aleorlocalleYel.lio locali$hadinplcnBnkdall of thcse
mmpone|lb
i,r
jnclu(HtheiecomFnenls:
DiteficomllFalthpmgrams
Promotion
mdeducation
Pftrention
Pdmalrcaft
Rehrlilitatlt cim
Pmgrams
wilhin lhe prirrlc andptlblicsecloBincorporated
a \liricl.!of aclilitics.
including:
NerGas\ei\n|enl
Polic,tdelelo?ment
S€iiceandpogramplaflningandimllemenlaton
Evaiuation
liinanci,lgs€rvicls
Prorisionof scFices
Humrncsouarsforpr0vision
d ssvices
Crn$lbfionandlrchnicel
rssistance
Coordin?rion,
collalontion,
andinbgrrfionofactivitils
Coalitionrbrloprn€
foredrccary
Inln\rtntioos
forirdjvidual,
cornnunity,
?d gof€sional
edrcation
C€nain
oraldis€ales
,rd @rditions
addr€rsed
forpar'tiflrlar
age90|46ard otherhl8et
6as€d
o0
factols),
iffluding:
ttu{6
+ecificdemogrrphic
(loottd€aay)
Dental
cad€s
hriodonlel(gum)dii€?ses
ftal injuri€s(ftornhousehold
fal\ altomobile
,aci&nh,I[crealion)
onl clft orll habilitation
seMces
ofil crnoer
odlerorrl conditions
Primary
provid€d
dmughconmunily-basd,
schmt,based
Frftnti\Emeasrn€s
oriadivid_
itftnlionst including
yrhr ortable\&oF,undvitanim
optimdfluoride
inlrh thmugh
Ibpirl fluo.ides
in loodpasE,
mouthirse,
erdpmfessionally
eppliod
tratDenb
of
4pli,lion &nt l sealanb
lhrry faalors
liniting crriogenic
food in maalsbelwenmeals,
andbde feeding
of
dzlb inepqriahb
Onl hnienemea$ns(horoughdailytoothbnrshing
witr fluori&loothDasb
ad 116,
i$ useofantimisobial
rinseorbodpash)
|}efthtulhabib(weringsealblb, tr€lrEb,,rd mouthguad)
lhinencefromuseoftobacoardalcohol
llumrcusoralhealthcomponenb
rErcintegrated
ri$in dircrs€pmgnmsaspartof
prcvbio[Iollcningalt some
0rservice
oftlEprogmm
inbraatiqsanda]liances
dnl
mngprivaf, public,
ardnonprcdt
agemies
ardorgani.aliors
atn b andloaallftls.
Idiaid (trdexnoP|o9ftrtr
blzid [edyald Pedodic
&nening,Diaga6is
ad'ft€ah€nlFogrrD
I&nal andchildlEalthptogtutrs
PnoeblnaEmityendfrmilyplamingptogrrns
S'ellbabvclini6
Progran$
forchildFn$ith{ecialhealthfteds
childhealthprcgrans
pmgruns
Adol€scent
foodProgran
forvbmeo,InfanEandchildm
special
Supplenend
HedStanpmiects
Earhintenention
0mgrams
populadon
gmuF
senictpmgrrms
forspecific
Health
andhurnan
\{i$ ph)s|(ll,nd/orm€ntl lpalthdNrhlues
Pe6otu
Youth
andaduloffendes
Narional
HealhSefl/ice
Coq6
pmgrarns
lndianllcahhSenice
Crnlen
iligrinl Heallh
CommLrnit!
Ileallh&nt4ls
programs
Health
Care
lortheHomelos
CanCentes
Primarv
asdiations
andclinicians
n€t\rolk
Pnmadc2Je
rlluftx4; hoqritel-based
clinicsandorgani?4tions
Public,
nonpmfit,
pmtectDn
agencies
Ennronmental
healthandenvimnrll€ntal
(pt€chool,
prcgrarlls,
el€Ilm_
heallhplograms
Statlandlocdduaatjonal
sucha! school
€ducalion,
consum€t
educalon,
migranteducation,
commuoitr
tan ard secondalv),
prc&.siond
educaeduc.ation.
conlinuing
educaton
andirE€rvice
cli€nrpatrent
education,
uniwlsiryafiliald
lioo,veationalprcgmrns,
college
anduniveGit)
ducatioopmgrans.
faciliti€s,
,ndara herlthducalioncente6.
gelvices
Pdval!sadorpo!i&6 ofh€allhandhuman
gouF
Mvocacv
pliqrnakeG,
Publicofficiah.
d€.ision
malets
State
countlmmmissione$,
ciltiandlocalcouncils
legrslato6,
State
andlocalcfimisions,conmittrrs,
dvisorygmuF
llpftsentalives
Private
insurance
organization
B sioess
€?lsentathts
grvinq
pmgnnbendfdnddionnp|tsenulws
CorporaR
Ib
I
Sbortcoml.ngs
FollordnS
ar€tlEmaiorslprtomingrd oraltral6 prog?nE
idrodffdb ,I]o*glDuFat
tu ReSionalwoftlmf6.
,Lad.^..---ri+ta
Go||.ciloi, l*doi,
rd ia-adr
De$iteirnpowrsts in fie onl healthof childnnin tllelal fw decrA, th€ftcrnain
significant
lerelsof Fwnlabl€olrl dilea* arioflga subizntidFnr .ge of childftn
andfamili€s.
to the&tdnenlol tllekorcrallh€aith.Manydilsavssuch,s &ntalcarles
(including
ginSivitis,
bablhttle loo$ decay),
mdocclusiom,
onl
Fdodontaldiseale,
iniuri€s,
ad ord muaGal
ksior6anDnt,tlhble.
,kerlbl€dataindicate
a hi$er inci&nce
ofdlsease
dd high€rlelrlsofunrm rEe&sit|.
inttlefollo'dnggmuFofdfldnn ardfamilic*ho:
. harrAecialtEelthDee&,
. liw in no0lluoridabd
areA
. hawnoacarslop€wntir androutine
heal6carc,
. harelos irEofil€s
ardlimitededucalion.
and
. hlont loadainra.irl,oltuml.andedmicgrors.
Ar&ietyof modifiable
fa.lors-includintattltude!
andb€har4ors---rontdbuh
h tlE tsrisre ofdmnicoteldisa.es
orpooro|zlhealrh
sarrrs
in childllnardfdnilies.
ff: kno*'ldge.
ard afiitrdeof om provilers
expedence,
hinder&Itury of 4pmpriaE
fil p|ElrntirandtleatrE seflia€s
tochildftnardfalnili€s.
OrErdv available
dataaft ina&quale
to caLgoriEtlleffids ln omlhealh$arlsand
&|ld rsam€ntnee&d al'riskgors vilhinSatsandlocalaltas.
(hmonsl|rl€,
Ittt hasbttn aninabilitylo docummt,
or evaluatthedectirm€ss
of
(l)
(2)
pogrrms
bl$
of iosufiicient
because
data, la.kof appmpdalr
useof exjiting
(3)
and
o.ai
he.lth
sutus
d.L,
ald
la.k
of
evaluation
*ills,
ftsourles,
ard
Fgrunnatic
Fpa@ws.
lbr b aneed
!0 integmle
orallp,lth cornpon€oB
vidtn healttrcseadrandevduation.
It
hasbeena l..k of ft.earchander"luation
in onl healthcoryon€nr,nd &liirry
yilhin fiaEmd end
grr't asvrellasin publicllealthurd clinkalnsearch
aalivities
dhel$progm.
Ii...t
Codnbi., Co0-or.6oi
Sr
trepublicnorprdesional
provi&rs
FEeiElheimgonncedoal halfi forchilrh zd tamilies.
17
olchildrnind finilies
hexldr
]lelt hir,ilxtn li itdelf|tllreid\o(m {orLhcord
lo mlhhoflltred$ti\rN\ilh gr)uprsupfl)ningchilTheRisr nLtdt)!omlbedlhgtuups
drcnlUrdlmll\ i\surs
'Ihenhr lten n fulureto i&f tjhrderlop.Jrd tL*pnrfcsio'nlandconuruniN
ntt\r'ork\
lo suppofi
onl heddrNuesaftktingchrldRn
xndfir lies.
Accaaa
cenrLin
rcgukron:
xdnndisrxrNe,
$ eonrorrrc
bime$rnhrbit
theEuit3llefl rffec a
oflLl
dinribulioloi fiorideNmd tlledel\'eNol
rnice5lo.hi]l)B\rotr\tr$d ircillrnent
rlrcnlu tmrili!5
oi childenlrlldlinnriieihr\e irsrrtfrcienl
tii rcii le\oLrrcLs
lo
A sigliiicxnlfroJ)ofti(xr
oblxinoril pnrurti|eind tlfrurkntsenrc6
Policres
ln f(fdd to cnsule
thirlchrldrulxndf riliLshaleuni\errJx{cei\lo qrpfi)pn'
3lepe\tnti\r flld tb(ri{reLrllc
orxlheilth:€nicli
Pollcy
'lhe€ ft insufiicienl
fin3nclillircentir!5lt)roridr xl!()phrlc costeffedl\cpNnntir€
*nrcei forchildrnmd i nilie.
M|\lurt€rt:.urces humxl.ph\\jcJ.md frnxncid ftrd lo tx conmindlo ms.'lthr
oqLlhedth
nedsol cltildrnrurdlanilies
(ud oftrnjnclude
lich dr'quare
Plrliciei
InctntirL\
d$ircnlrfs) forefletliremd ipfro|nxtr prnlsionol omlhrnhh\eflic6.
'fheftj\r r)edfor
\ rlerlluondxtior
nolici6thit\uDo( conmluniq
Qnaurffi)lidcrrmdprlientdisrocerrli\ei
ner.d
to h clininrtdl(eg. reirrhurscnrnl
r3t!5
rnd f|t {hedu16plpnor\ proctrr*rnd nrcchrnrfrns.
eligihiliNcdlerir.i{rtion ol
) lo ulcR$ei]]rdimp(nl pnnision
to dlildltn
scnlcLs
of lRicnlirt drd teahftntsenicej
ftrdfrurllie.
Mtquilc qLrxli$asurar)ftlLlrdiccou0tsbrlil\
nrcchinisms
ilr netted$ithirlo.iilhe.lth
.nd nrdemrlindchildhe:$ prugrums
(Lxl md gc0cml
helldrcrr s\stlnrs.
dlucxlion.
andftstalxhj,'r txDrlri legnkd.fius
.l rpnnU\.ngrllF'irr.,Inprlur,.lJh,ldT
l iu [.LnIli(.
I nilonnnr)dmL\r)lcm (lF\entj\t x|d cur.rlirt)nLri lo bcesl:rhlished
md utiliz€d
ior
c|ildren$d lxnrili$ trnclLrdjng
infrnts\oungchildftn chjldftnsrlh sp$ialhtal$
r€d\. xndrd('l|3:enlc)
Sli[drftlsi)rora]herlfil)tl)gfulr)s
rndrDrtemdxndchlldhedti progruns
hlre not
unrfomrh
ipplie(l1$rrheiFcr rolNgirnulxricisurs.stxffing.l)cdion.
md
r!ilhif nulrnrxlrndchrldherl$ pfi)erl(rrs)
Cd lLd|t tnordc
lLa[or
llllE isr nood
-dpm&.6imdb inbgBleorrl di*asepffintim andonl
b odrrd healh
h€dhprmotiotr
Coonuni$dr hasln hrdl d€dir€in pDmding
ploGronl diease
prt|tntirrml'ts
6 tuhnningddrhllid€sinE\ heal|handhnro semce
p**lorls, aodtE publh.
Pruttrpftrd*i* |rErts aft flrt rniEsrly 4plkdd ln€dbytr publtorpdir*urzh
FUIUNE OPPORIUIIITIES
ATD GHALLETEE3
lh! .lt rrcogdnl{ld6 b.tcEn tE Ndad voillhp dd 6. Rdm.l krhhe6
fi
n{.d b dEinB d.odfd lrd fu rnt8b outli.o(hn Ecurns|ddS6dfordon
l6E&.ltr Nrdoul rklq srscd taE film abm& F q.dq
dioiog $tgf! b infi|lEeq[cn dEng6d r n4idd Lrrl Rr.mldrflo.! L{td
tub
bec.nidqn6tn1r artiml lcdbyoaiozl4odc 6 gDr{.,rd i$!o$E|ty
+ltsbddftr6
f t ircofttpclt inrG {d hc.liti!
lb R.gicrl ft*Crq! .lbEd r d6 anm,tim 0atr hE cih ooa Ft.ilogory ooocdtndcrl lrrl6 tsE tr lightd bc.l fels {i dt|lEtrE
hrrr h ]h frftn oub.nEddEe talseihir odlhdrr bc.h.
drft@ h tE mdfuF fk tfd !pecm.,ddrild dds h dns
2t
s,etlh I
doa6.rt|r.
bE d re
ACTTON
P|-ANS
toGAtLY DTRECTED
Reglonal Worksltops
Atftc Regional
$'odshoF,
lheslecicin of theisuesandstntegieallo\rd$o* gouF
lo dcsignate
lollowupa.tionsles.idendry
mksandtteorlsibilities
forindiriduals
or
dctail€d
forircomplishing
ltle5e
organr2rtions
h carllinSoutlhealtionsFtr,andesullisha timetable
steps.Somc
of theoralheallhisuesaouldh solved
oo a shonlembrsis.witha sp€.ific
imetxbleandeadilrideotfid r$ponsibilitrea.
ofier oralhealthis\ueir.tle moftcomplen.
of adionsteso\tr ane(end{ipenod
Equinngimplementation
of tinl€brdiYeMindividuals
xJ orgenizxlions
wortingin collaborxlion.
uith specific
coreeondingl\someof lheactionplxff rcrc rcn concise.
actionsteFi
plrns
toa.livate
ele\rFiorilizdst.drgrs.otherirlion
we morc&tailed.uithehts
designed
oratedqdptionsofmuhiple
long-.ange
andshonlerm
nntegiei.Inmaq caca,actionplals
sleps
forcontinued
suppo(monitJring.
andFfinenot nsied lo a.complish
incorgrr{ed
the
RCO[end€0
a.lons.
vbrkhop
Th6€lffallr ditrtd aclionplanswe 'dnimportant
oulconpof theRegional
joindt
proces\.
1lEseplanswrc lhe|siull of eachgloupea.hingcons€nius
outlining
and
isues.Stat6ncedto suppon
a.tioNto addrsipriorii?ad
andencourage
bolhplanning
rnd
implern€nlarion
lor1h6€a.lionplalrsorsinlilr goupaalions
!o aldft\sfutueonl
$rittrgies
heallhchallenges
afrecting
children
andfanilies.
pronosed
dhected
Nction
aI the
Thelollowing
descfibe
thespectrum
of locall_r
steps
RegonalubrkhoF
Lada Aaaaaa|n.|i
'Itr $atemrlemdandchildhealdprograrn
willcoodinaE
colleclion
ofstatesJEcific
onl
(e.9.,
heahh
drtxfromestIlbljshd
data*6
wlc. tobacco
rnd healtholfice.
EPsl)T.
fluoridrtionGnsus.EehafionlRiskFa.lorSurct ritel sralistics,
Crnsus
Bufirau.
state
in 0|e
educato0
&pariment)
toevalual€
thenee&ofchildrcn,
andincludc
lhealiasirrle0t
annual
slxleheahh
epo(
And hocplanning
sill s€el!thmugha formalllquisition.|e[rhtucxlasis
cornmifar
fom thetublicHexlfiRegonal
tlnceandsuppon
Offictroaidi0 planning
andimpleoralhedfi nctdsarsasment.
menting
a$atc,^ide
Advocetr, Coalluoia, Coll-o..tlo||
$ill formalize
Theslate&ntd dipctoraft thestxlepesident
a coope.alin
agreement
tJ€t$len
theslateo.alhealthofficein theheallhdeDartmenl
rndtherlaleaujiiliar'!!othe
dennla$(riationforcollaboaatjon
in pro\'iding
iftieNice
education
tochildcft prorideF
p!$.hmlonl hexhhmodule.
albutlhcstat€
2)
l hep|esidenl
of lheslxtedentalassociation
andthe$atedentaldircrtofwill formallr
rcqucsl
fie appointmmt
of r dentalpmfesionrllo 6€ alecoodinating
commi&rfor
hcalthandhunrarseoictr
publichealthewriatjonljll formallrGquest
Tie state
andnommate
a denalprof€ssion
on
xl 1osent $e heal$con)mitte
oflhestate
e.\sociionofegionrlcouncils.
Tlt stntemaremal
andchildhealthdiectofu'll appoint
adenlxlprcfesional
10fie adi
sorycommitteoflheslrtemrtemal
andchildheallhprcgmm.
Acaaa3
Alitatemelilion(e.9..stxtecorli[onforlpFons{ith di!$ilities)\rill prcmulgaE
anisue
paFronthcsunlsoforalhealth
senice
affess
forchildnn$ifi djebiliti6\rithlntr state.
Pollcy
Tle$alep€dialric
dentda.\srxielion
mdp€diatdc
\r'illcoNenc
csoci,ltron
acomnli[e€
to
p&kettonurdirlromlhealthe\aminahon
fors.hoolent^
F+arealegislrriie
$ adhocconmittee'.rill
beconrened
bl dc statrheallhdepartnent
thepnati'
to assess
calilvandlogicalmeriun5lo implement
elts.nxlins{c.9.loanforgt\rness.
L1\incen
lin i) lo inclease
&lir4 ofomlherithseNic€s
in un&r..i€nrd
cuurunities.
Thesli{edenlxl
willinclude
{ss@ialion
asa pdonlv
in itsannual
leghlatre
agenda
lhe
(induding
rEiomoftheNedicaid
EPSDTprogram
srppofl
lorincftl]ring
leimbursemenl
panicipalinS
feeschedules,
increasing
of lfi)lidc6,tuidstrelmlining
for
theprccessas
,rpplicalion
mdbillinp/lEimbu6enent).
ThestaledentalaslriatjonandstaFhealthandyrial scNice
$ill a\sri$anddocu
agenc\
nrn! in a rFn $€ $alusofbfiies thalnegu
tiNlr i0fluenfftheparlicipation
ofd€ntistj
rntheMedicaid
|:PS0T
progranr
'lheex.{ul!edimtr)n/pnsiden6
of x coalition
oflmiei\ionalorgerizaliom
.lndnonpmfit
o4a0i2rtions
*ill for*fid i lctterto legislar1]commin€e
memk$ff pEsenl
ldtimo
a!legislatrrr
herins lopnrlcnlfie nduclion
ofomlhealth
enicecorerage
in lhe\ledicajd
foridul6.
Dn'grrm
Oral lladth Pro|||otloi a||d Edrcatloar
'lhestatedentaldirector
andVICprogmnl
diectofwill m€etto plen|rneducalion
ca.il
pirgronpmrntionofbab!btlle tmthd€(arl
StlfrmembeN
of tllestrFlobararandhealthofricr.shml healdr
otrrcr.andoralhealdr
office
$ill mttt todeitlopa$nokeles
prcr€ntion
proje.1.
toba.co
lht nnbdenhldiltttor*ill corrlrrtlheeditorol $e stxtedmtalassocialion
nerrle[ter
lo
e$allishanag€emenl
lo rea.livate
a rcgulirrcolumtaboulord healthissues
alldpublic
herhh
updetes.
2J
o[lheaaakalth educalion
Slafrnremben
ctnbrandtfu staleoralhealthunitwill meet
toplananducaliondon b review
localoaalhealthneeds
prcrcn
andcommunilv-bas€d
tirem€,lu€s(e.9.,
vat€rfluoridatiofl)
community
]tich canaddrssttrese
neds.
matemal
pmgram
Stafrmernhsofthestate
andchildhealttr
willpianar inseNice
educa
pmgrun
public
iion
lor staleandlocal
healthnurses
md rocialwo*e6r€gelding
oral
healthneeds
zndscreening,
refenal,
andfollow-up
intotE defllalcaftq5t€m.
stafrmeml€$of thesulemalrmalandchildhealthprogrunandtlleoralhealflofiice
will anange
withtheplanning
cornmifree
toinclude
orilhealfilopics
asanintegrrlmmponent
in theannual$atflide
farnilyhealthconleenct.
'nr slabdenlzldirector
anddjrcclor
ofthestaleoffice
ofnuaitonwillplanapaneldis.us
siononbaby
botleholhd€aay
altheamualmeethg
oftllestaledietetics
asocialion.
RECOMTIENDATIONS
FORAGTION
Asignificant
numhrofindividuab
zndgroDFfmmallsech6--Aublic,
privat€,
andnoll
profit {aw fzr'reaching
inlluence
policies.
pmgrans,
on
alldseNices
afectmg
ttleorrl health
ofchildenandfanilies.Individually
orcollectiwly,
individuals
th€se
andgrouFcanlak an
aatir€rcl€atlh€national,
stxte,
orlocalleleltoadvance
po6itilroul
a.liollsthatwill influence
comes
fororll healthissues.
ktionsar Fcornrn€n&d
onth€followins
fmnts.
Advocacy,Coalnlo,Colldofadoi/Accaaa
,{dvocat
forunh€tsa.I
p€wntircmeasutts
aacrsfor3llchildren
z.ndadul6!oefrectilr
ard
basic
lEalhcar€including
o.alheahh
seMc6in futuer€form
oftlrchealdr
slnremAccaea
Initiateandsuppon
chang€s
toassljrc
increa$d
andimproved
arc€ss
toor, h€altiservicrs
(public,
withinall s€alots
pdvale,
2ndnonprofit)
at all lerrls:National,
slab,ard local
(including
city/count)1
pmvider,
andpatimycliml).
SuppoiandmcouraSe
national,
state,
andloca.l
lerclstopmmole:
L Modification
zndenaatnent
of strategi€s
ftomtlle Regionrl
Vorbhops
including
slat€wi&
coalitons
ardg?$roobnetcorti,statewi&
needs
2s€ssment,
endinne
vatlve
progfiuns
lo incca€aaces
h declff se ic6.
2.l,.b,ieyeneflt
d Heltb! P@ple
2rr0 o|]l he,lthobieclins;
Implemenlalion
o{oBM'89
proyisions
conceming
orzlhealfi;
3.
24
4 lrnplementation
of rccotunendations
oi thePubLcHealth&rvicevbrkshopon the
oral Heahhof N{othels
endchildr€niaM
of fie aloveinilialives.
5 Coodinatdevaluatonerd as\€ssmenl
Pollcy
Pnmoteard supportinteg.alionof adequale
andcllcctin oral healthscfliccsin hedlh
andhumansrvicepmgfi dunngth€plaining,implementation,
andev,alualion
$agei
ofpolic\dewlopment.
Conlinuelo r€queslanddeme.rd
an apprcpnale
andcfft,.tivrorelbedthcomJ)onent
in :tll
policiesajrdprcgr&'Irs.
healthandhumanseNice
S€landenfoc sgndadsfor qua|q h€althsen'ices
includingoralhealths€ ices
lncourage
allffrtionofsufficienl
Rv)urces
lororalhexlth
seflices.
REGOMMENDATIONS
FORTHE
XATERNAL& CHILD HEALTHBUREAU
Ite trlatemallld ChildHealthBueauhesr k€)''ml€in pmnoling,$imulxting,supFrtr.& 3ndcd)rdinatingfuluc aationslo impruvetheoralhealthof chiLdftnmd larniliesin the
:l]lrd states.
TheRegional
Vorkhopsrccommended
thalthellaternalaodChildHealthBuleau:
. Inlegnteeflectileard amroprialeoralheahhs€Nic€s
vrthin Tltl€V BlockCrull guid
provhioni.
mceandfunding
. imoDoreteorxl heahhinitiativsiintos!€cialproiec$of r€gionala.rdnalionalsignifi,
(SPRA\S).
cance
. Slrcnglhcn
sistems
de\€lolment
t0 includeprcr'ision
andlinancingof conlmunit_v,
b6ed,fanrilvcenterdoralhealthseflicesfof childrcnof rll llgesandfamiliei.,nd tsr
$$ qith qtcial healthnc€ds.
. Conlene
a ni onalfomn to eessess
thr ecommendations
outlinedat thefublic lleehh
SeNice
Wbrkhopon ofii Hcalthof VothelsandChildren.Ihb forumn'ouldpmrid€&r
(l) fcatureeffeatirc
opporlunittto (l) oudinean a-\s€ssmenl
of ther€comm€ndalionsi
orxl h€althpliciei prDgrams,
andsenicesin oFillioni (3) refinefutue dircctions
to
addrers
famil,voralhealthisuesi(4) fo(usettention0n the i$uesthatar€es\enliallor
u:llje\l,nlthe Ha lh! Peopbr00, oml healthobjectives
lor infan6.childrtn.ioutb.
xlrdf.tmiliesifi]d (5) dirrminate infomntionandpromoteadoplionof eflectir€orul
healthservicaandprograms
2t
. Expand
cmperati!€
mrk ri$ ttEtleallhCartFinancing
dministraton
o fa.ilitahcru,
cialEfonnsin t\e oraiHealth
ComJ)onenl
oi theledicaidEPSDT
pmgran.promotr
xndsuppon
poliqchanges
loi
L IncFa\eaacess
townio5forchildreni
2 lncea$eimbuiiemenl
rdleiandfrerhqluleit
J. Inff$€ thenumhrofdflttalpruiid€$tll"ough
tlcruitntent
andrclentiolslralegicji
{. SftimlineardsinDlifibillingandntnnenlclaifl prcodurs:urd
nrm:sseta
binie$toerulllllrnl ,ndsimplifiapplcdion
5 Rrdr.i.t
pmcedures.
. SupF)(inrtialr\t5
to:
l. tr{odiftandena.tRrgjonal
$brkhoFstr"rtegiei
rhmugh:
Dr€lopnrnlofsFrcial
pmiecB
losuppon
sklewide
coalitjons
andglass()ots
nehxorl$
promoting
oralheali:
StaL{idroralhealdlnee&a\s€ssrnent\:
md
Mo ion andopemtion
of innovttileprogarnsto increale
a.cess
lo cff€(tive
onl
hdth senicc.
l. Implement
fullr fie 08RAE prorisions
ltlard tooralheallh.
lmllement
ftcommend,ttior$
3.
ofthePubliclledlthSaFice
U,orkho!onoralHealth
of
Ilotheni,ndChildrcn.
a..L.hifletv ulthl Peqe 2A?0objeclirts
foromlheall}l'I heBLreau
pmshould
vidrleadelship
in coordinafing.
evaluatl0g.
andas.iersing
d|efirit thErinitiatirBand
should
assist
in moniloring
tlEfounh
. Lisc
fundjngmeahanisms.
granlandotherguidance
pmvbions.
tndliaisonlinkeges
lo:
L Pmmotr
policldeEloprnenl
forunilersal
arcess
pr€lrni! mea\uftrs
toefiectire
,nd
basic
health
car including
otulheJ$ lenices
2.Suppon
adcquab
andcftectjlromlheilh senj.6 in all healthandhumiulpnice
through
inlrregrnc\
al cros\sritrnlcollahorrlion.
lx)licicirndptugfinrs.
lholurage
d$dopnrent
o{
3.
or. hexltlellt$ in hexhhxrd hum:useflicepmgrans
du.ingthellanning,inplementxtioo,
ajtd€lduetionstag{.1i
olnolic\dr\elopment.
.1.Initialtchang€s
to incea* axdimpMe&cess
toore]healliscrvicct
withinall sar
lors(public,
prirale,
andnonpmfit)
andxl rll lelels(nrtion:. nxtr.aitdlc,aal).
Dcrclopmcnt
atlheloe levelshould
comider
mruticipllmd counoiurirlictioNas
\rlllasinitiaws $epmrider
udlatenl/client
l$rl.
5.Btablishandprunrrte
cnfo@ment
0fsundilfils
forqualit\hcddlrnic€sjncluding
orulhcaltis€rvices
. Suppo(
lheallocatioo
ofsullicient
reources
foror.i hmllhs€flices.
26
APPEI{DIGES
APPENDIXA
Iltgbfigbts of Regtanal Work sbop s
'ft8 Regionel
Vod6hoFi
rncouiagdeaahrgion to h inndatiir,andpDvided
Aeaific
o?potunili€s
irsu€s
todenne
a..!ding top?nicllaregionalp.ioritksandneeds.
ftis flexibili
tvrlloredeachoftfu seimnod$hoFtodftlq indirtdually
bystrssinS
dillepnrhpi6 wifiin
tE agsda,nd imoqodingvrid fomdsfircughpla|rEdgmupe.livitksandinleaartioN.
In ddition,dl€audl e al eeahsorhhoprEfltsent€d
djffepntcombinafiorb
of gmuF,rd
dr
rfie
oubofiEs
of€?afimrkl|op
unique.
FTedirt' Til\
Thisseclion
highlighbSeciala$ecbandencaFulatstheactiyiti€s
of tl|eindividual
FrlstroF. Ald|ough
it isnotfeasible
tocolllpdEffivtlyrri(rx all aQe.8of6€ryxDdshop,
(See
full rcpofls
of exchx/od6hop
arcavailable.
thecitatioNou inedin app€ndix
B:
&bliography,
ardcofltzct
th€soecific
ofiice
rgionel
o{d|ePublicHealfiService
lisld in 4pendr D,page
47.)
htbltc Heqbb Sefltce M*enul
and CbtU
Heshb coqfererrce,Pubuc Heahb Senlce Regtor.t L
ard UI, Apnl 8-9, 1991,Princeton, New Jersey
Vodshe fartkipanbrcprcs€nled
st b ald locelptogranE
c/ithinPubllctlealtrSenice
ReSiorE
l, ll, andlll. Iie paflicip2flsincluded
rcpEs€ntatircs
ol manycommunityb^*d prcgrams,
includingdentalhygien€
anddeotalschmls,ho.pitals,
communiry
heallhcent€ls,
localherlthandsocialservice
depaflments,
ad HeadStangrante€.
govided
Ilt€s€partkipanb
dEvorbhopr{itha localpeqectiEbyaddr€ssing
commmil,ri$6 UutrEd toh considered
forfutultplogcri.
Tlt codshAFsenEda $mrnrtl of ec€r tbrlop|rEob,nd o?pon0nitj€s
lor imFw
ing6
lo ord healhsen'icts
priority
ad ftssedtE rEa€asity
forincr€esing
ofoml
E
ttaith asaoesentialomporEntof orcrrllhedthcatr. Abo,UEs€siorserarnindbodr
tlE ch,llenge$
anddE potrntial&t€ftrib in fulfillingthepot€ntial
of ecentpoliq .r|d
le8islatlw
initiatiws.
Rouodlable
diedrssixu
foo!€donasessing
stntegbftomfed,
Flblcrs andlornulating
grrdF)iob.
gmuF
errl,lat, orhcrl
pdodlvis$€sardhdn€dstralegi€s
TIE
idendfied
lo integdeomll|eal$vithi0 th€contqtof malemalard childhealth.Plenary
and
tuurdLbl€s€.sior6
brouSht
hgeth€r
a nulidisaiplinaqcoalition
of ir onnd dvoca&s
eilhinth€egiorblo supfbrtpotcies
roinFolr tlEoralheal$ofchildpnandfalnili€s.
29
Public lle.thh Sen'ice Regiofl Morksbop
on ()ral Heahb
oJfMothers and Chirttren, Augusr--8. 1991.adanriL.ce()rgix
Thjs$orkhopconcenirrted
r)nfie slatusoi orrl hmlth i$ues\ithin thesoLrtheestent
Lnrted
Slrlr\ \the e oi dre{orkslrofnaestabltshlng
orelheiilhest ror i.legralptLn
otlhetotalheelth
crtus\slemoneunique
$l^.clof lhis\,,,0rk\hop
$i5 thepresentrtion
of
plnneFhil5 lthletn pLtblic
lxrdla\rte srctors
$tlhin
op€rating
thercgion the*laflner
,\x\\ ol infohinggroups
shipsieetLrred
inro\'irtire
rn fhnning xndintplemenli0g
F.)
gmrns
thit lrrcrll&xcctr\toconxnuniIbisd orxlhexlthsenic€s
sesslons
PlenxN
prolided
\rith irno\tniewoi fir monrttentjnlluences
lir xudience
on
poljcies
endsenices.
indudingdtild heelthsLtFnilondMdardsFederalll
Qualilied
Communil'
IIeihhCrnterfruvlsions
olOBR\ 90 3ndfrovjrimsof 0BR\'8_q
dlatdfe.t
\ledicxi{l
IPSDTard Titl€\ \lelemxlandChildlledrhhogrxms 110del
tr)grams*re
ftliewBltoddrrs lilun trchnicaln€ed\
tofst Fgnll.rnningfroce$es.
inplerrenntion
ol eflectrtsrmcn md fullroprnlngprogrms
(nrerim olthis$ofubol rrs toenrphasize
thepeNnnel.
rlsourccs.
xndmethod\
thlt ire
cfuci:tlI implerlenlnq
slrxtgl€! Exchnile $rs rpresrrrtrd
b\ x ()rp gfl)upof pxnicl
prn6 end\relded
tor strtes$tre out,
lnduatj\e$orkgroups€sslonifittuft dir€ctiofs
linedin eg€ndrr
dr\rloped
progrcs\
to stimulde
in inrproving
orelheel$nitLtsol.hildrcnlxrdl3nli|l$.
Otal Healtb
for
Mothers
a d Chidren
in Pabllc
He.,kb
Senice Region V: Blueprint for Actdon, \txrch --8. 1991.
Chicego,
Iilinois
Thisrorkhol incoryonted
orgr.ixljon
F$pecti\rsho.r nltj,rnxlhealthprciessjond
md iedelxlxqe|lcies
$ithinllrc4rndx ThisrpFerrtxtlonlroid€da nxrj{nrxl
\ i€$loitl
onissues
gorl
rnd RinJorccd
the
oi inleragencr
mdcl(\vr\stem
collabofalion.
Pltnxns€5sions
retlecled
md fri\|rre\e(oA SFeke$prc
Frs|rcljrr\lrun bothpLrblic
snledthei.a\srsnentol 0r1lheelth
issu€s
md 0 tlineldifteentoptions
to .ddBs jdrntiliedprobknrs.
Iork gr rpsde\'eloFd
blurlrinbdtetctllncrcssdj\rrsr
issnes
andinlegflt
ed$rrted€stoincllrde
cl)lltLb0riltile
eclionixt the\nle l$elb! e nu b€rolo.glnjzttions
,rrdr$ncjei
The\ro.khopidertified
fte€ssentdne€dfofeffecti\t
meNures
to recruit.
r€lrjn.andsLlp
prclessionah
dcnlxl
to
rfxl
he3lth
senices
irr
rndrArnrd
comntlnlities
lotl
lturjdr
jNre
Strxtegjes
oLrtljned
to ddms this
included
rllcmxtilr\\uch$ ta\ incenliles.
lom
forgileness.
endincrelNtd
ll]jnibursenent
pemlcnB
fmnithe\ledicddpmgmms
rnsptcii-
.ta
Publk Heahb Sera,tceReglon VI Vorhshop on (h4l Heahb:
A Vltat Compor,ent of Primary Heabb Carefor Mothers
.tnd Cbluret\ Ja^!xrr-2l]-29. 1991.Dallas.Texas
Thisworkhop
locured
ontherecent
legislxti\'€
,mdpoh$iniliatives
inlluencrng
oral
hedthisuei il nelior)ilandsreElenh At$orftSroups€ririons,
rachstrtefomulald
sti"ategi€s
to intcglrt€lh6e ne* dertlopmentJ
intos|lteaationplaJrsEeahnaleffiucd on
o.al hcalthis\uesa-nddeYeloped
an initjal fraine\rod(of laclicslo €\pard uponcurftnl
.Lcconrplishnrents
and!) soll?d€ndliedisues
Thestitte$orl grcLrps
discussdissur\.shircdidcrL\.
andconlemplated
apprcaches
to
problemsolring$ilhin indiridLralndes Uoft gmuF reflected
uJ)onvariou!stmtegies.
IuluB opponunities,
chall€nges.
andpotenlial
constrain$RelF..€nlatiles
fiom state
dlocao groups\|sr invohedin thesmallgrcupdi\.usions,nd pro\idede uniquetsr
progrtu'ns,
specll\con thc tacljci n€eded
lo imprur'eofi heihb pohcles,
al)ds€ icrs al
rtalemd locall€irls
Acomllontheneamongthesa*ork groupwasthedorlopmento[ strirtegjcs
to me\rorize
inlersgencl
andcrcss-\\slenr
collaboralion
thrcuBhadv(r:rq:plirnning.
fi prcgrrjn
implementalion
$rreoutlinslb enhmc€
Reconrmendrions
e\islinS
oralhealfisenice
pmgfirms
to Rit.h &ldilionrlltslsoni Ub groupspmposed
t0 hcre$€ a.cesslo sdnicrs
b\ erileDdjng
p€renlionind educalloD
lledicaid|:PSDllaugnenting
rhool'ba-{€d
lrograms.;ud exfandln8communitrheehheduc jonprcgrarn5
In addition.
*ork groulsFcomm€nded
a sccond
\!rv to inpflrreeccels
br int€grrling
orslhexllhinilixlirl\ intoF)licies
\Ibrkgroups
xndpmgraJns.
sugL6ted
lhrl orilheaith
bcintegrated
irto pr$ention\ericcsprolided
il sahool,based
dinjci,incorporated
into
lheeducalion
illd counseling
component
01theU lC pmgram.andincluded
uilhln
on{olnsstatehedthneElsard dske$eisments.
Public Heabh Seia'tce Reglo'' WI Vorksbop on Orat
Health: A Vlrat Component oJ Hrnary Heahh CareJfor
tlothels and Cbldret April l0-lI. 1991.Des ]l()ines. Io$r
pr
Thls$orkhopenDhaiz€d
dccAsing
mx\inli2ing
senic{s.
rw)urtes.andincluding
\cnlircnrasuresA ple0ensesifi $ts\ed shafingicrossstalestd prc*nledlfor€n
rodelprogr.ms.Thesrplg€nt iorl\ sho$d ! communinbaldl b$\ bottletoorhde{er
a s4hmlb&{.lsDokeless
pfr)gflnrr.
lobacco
rducelioo
xn orxlh€dth
lrt€ntion proiect,
.|Ilt pmgraJn
tor childrn $ilh $r.irl ne€ds
on r mobilcdenrxl\an \ulpoA6l b! fie l:lk
(llLrb.old olherproi€ats.the prograuulianur{ rere prcrjdi g comnnniq br-s€d
srnices
Lnnrles$ilhin lheRgionard acnnsthenalion
31
thallur
ideas
andexFriencts
Tl|e$ofuhoppmri&danmlionmenttofa.iliuEsharing
ofnct$orkhr{€enand'.riflinstaL5.Ea.hslatewNq)I€fier pomot tr d€Rlopnrenl
pfoposcd
l0 mor€
strategie'
of participanls$b groups
sen[db a Fincrpalnucleus
(e
sts
oralheilfi \rithinstat€
ad l(rrl nmgrmr 8..\l{dicdd.DPSDI
dcctr\€hinEgrnE
seNic€s).
Srxt€8ies
clinicnlhealdr
senices.
ards.hmlbased
cialhexl$nftdspmgr&ns,
priorit\
I
in policr
lncersing
or:rl
healLh
:6
slesrd
the
lolloring
outlined
tte
stxlej
b
skle
end
oml
healft
nta*
at
xssrssing
andl€'lortirg
doelopment
andrcsource
rllocetion.
tos€nic6.:rndinctt^\ingcootsr'
locdlelrls,dudng bame6in oniertoincear{aac6,s
oqsnialions.
and4e0cil:sin all$'ctots.
alionandcollrtrorition
antong
lrolid€$,
Indtgettt Women and Cbluren
Orql Heatb Adu(racj,for
andJot Cblurea wlth Speci4l Heoltb Care Needs, Publlc
Heabb Sen ice Reglons wII and la Ap.il 19-20. 1991.l)envcr.
Colorado
of advocaq
al thest{e lertl!)
concenlrated
onlht impo(r.rcc
Thisbi€gionalworhhop
ouf
improrcarailrlilitr of oralheal$s€ icesfof childrcnmd fanilies.Thesestions
issu€s
to promole
stfllegies
foronl heahhadvoc&)lin€dadnxnislrxlilE
dodlegislirtive
plrn waspRsenldrc
tls€dto &velopaneftfttiveadlocacv
andsolulionsAhame\rnrk
spealth€dkusrionol rdrocaonps. pnresses.
andmethlllsln addition,
complenlent
oqanizations
&Iocao ar$tll |]s$e tolcoi proftssional
e$ dls.ussttl
intergenedtional
of this$o*
onemajoroutcome
onkhalf oi children
andf:unihissues.
$al adr@.te
pronbtillg
trskf0rc15.
ol ner*-ork
coalilioo5.
shope:rsdlecFationorcralil"lionol state
oralhealdr
lo b€
for modclproBralrlJ
Anolher
i m of lhc $o*shop\ra\ rc pmrideitrl opponunih
plcnxry
md
xdaplalion
of
theie
]'lrs
ss\ion
encouraged
adoplion
sharEd
rcms6stat€s.
\r)rkshop
pftsented
includ
rithin theeErons.
Pn)grrms
alIhe
b\ $ales
eflectiltp()gr.rns
pqmentqstem
scr\renlng,
nfend. rnd follov-uppogran.i roucher
d a schml'bavd
prc'
babJbollletooftdecx!plElu)tion
ser'licrs,
x conurunin
forclinicaloralhedhh
-ba.€d
heahh
cen:rndussofmigrul andcommunitv
dental
careprogriun,
iect.a hospilal-bated
ofmiSmnt
fann{!der rndchildEn
ord healthstNic€s
tochildlen
terfa.iliti€sh pm!ide
in Ileadstx( nrograns
ioriDproYemen6
bf a mxjoilr o[tht rork grouFNiL\d]cl italneed
.{ kerpoinlidcntfi€d
progmrns
strdegig
ou ind al
oralfudfi
in thetrl€rlicaid
forbotl childRnandadul6
paper$ork.
and
ralcs.
slreamlining
incttasing
rcimbuGemrnt
fie rorkhopincluded
orpttltnlinglductio in the
fordultsbr e€stablishing
thepll)gmnr
mpmlrngcolrrage
exNtnSprcgim.
A WvQ,asbtt,o
Zd ra @t{
Aedrb
Oat llaatb NeG& of UdbGtt d Cbutet h.bvc Haabb
glollx, Lprn D-.N,191, SanFrancisco,Califomia
fun
ft !0.fCt0p!.rstd cr6{rfrS bd6 od..rdd.cd fo hdicdd! d 6R ilo
p@d.i sdl ,! p(*iiaul pcacaiu. tlE pcscd trylicOood ddllstrg crl
halh d rd dt
6.1bli srt6 Er piEtd by. pnro!.dr"g odd
nfu rdbcrllog ndre lb hr oasndittyys di!.d h. p.ts.
e.r.nlntu
h. itdbj pi6 {d E dlt counruliry m 6d he.lbc.l! c
ffiltr C.!ftrdr llr ddtltdft! d& ddE 6 irlr w!,lr-'*i ltr.tr
!.e
.d.rldlogt|d fiutr. tr dn lFrIdtr.
ffior
ttr&lbulidlIr
Ib brod {d &rG d b adfop @rn8d $rtB rihin d b.lna rG.
ftr whlrop ftaad 6e foortoo d lftrdt 4lh.rt codnrekr b nmodq|l
blh bdE ad b dvro.. 6d h..lh qluaEds ApLorrt!.rsffi
d.uiiod
rq! b D.h dtt hF d[qtrb .dreet b.rnh6. ftri gu4r m$crd r 14ildrt |8air.r d cqq@[ itrrlt irDffit tr r d.t .dar pLr Ib drqd
d omFd ds r- rfu bodh d.ort FE
ldttl$tr.iw{Fdic,FntG
afftlqr Jd h lqcddm dp{t4da frlo b(!dt rd dr.dFliFrtp piumrd
dticfqbb
rddErdra.l he.lh!dddrtld'l!
'|dhber.
ll
APPEI{DIXB
Blbliography
Co.iidon
fororalfhrl$ oralherlhleiioi 6 ancs!€iridpanin nalional
heal$car ft{om. Cralitonloroal
ltallh,193.
pNnld d tll€h$lic rk lrh
rllo*i$ v l99l ofll hcel$,M inEeBlcoinff€ oatx.l lEalrncar. Pa{,er
5.nic3le8ionI\ 9od6hQotroralHerlth0iMotrn rid Chil&n.AdmacA
{luliin \t l9l ftr|ftxint anl lvl$ d a hith pnont fr nntJ|esdrd childrtn.PrperpR5.nd rl tp Tdktionrl Publklkzllh S6tie Ua&maled childolzl l+.llh cmffttF. PnDcdln.
!.
M. l99l. Shatngpollry
Aihkialr
to a.coDplbh
theEe l0o0odlbeallhobiccrivA.
Palelpwntedat rhc
Mdlon d $de .ndTmibdd D€iul D,cdo6,bnual\ktdn& Chadee.o.
sn
rluhrn U.I99l Th n€gl€d efl&nn:fte or]l hsJrhn€eG
oftu**zixt'm.d
cnikhi P.perplMEd d
&d tkald Mvoca.'v
forInditenlVo'nened Chllden{ forChildm*ith SFcialaedthCa|tNecds.
Puhlic
lbl0' SedieRedoftUII ltd X lhnEr.c0.
.{lhkia M. 1992.
onl bdlth ii o{r cut\\ f s nalmal tFalh nrryan-€rllri6 ud $n€Ct6 ,1rrr.r,
PtUtHahbA$.blrnA6ral
dk8,ryqla ,, vad'in$on.Da:tuftnc.nPlblt lhrlth Ael(rialon
of PublicSerl$ Dntis4 l94l lnErin polto sirdnenlon n?rionrlhsjd cm dom
trric.n
tudm.d.^ssocidion
\,| rmicL rscidio o{Publicfhallh0mli(r
.lonic,ll Dael lslxialim l99l Ch.rn8e
rndconnnui,iin heal$@ in tl* l nitd st lG: AF-slim p.per0n
G. brXi an. andrdmn.Chlcrtp'lrE*:r ftital Asci&m
rlltdcrll lud for Dentallkalth 192 D. {m! ndionalTnkcpt6onforft* inilaliw launch€d:
onl rlealti
W (rd ltulb 2M) Nqs l\l't I
MEi,crnfu'd {orUflrl fkalrh l9l MtE,
lL lrncdcarlundforDcnulIlsllh
ltzlbul @&,twn ndinro%I Eelt 2t1n. $,iit?.'
rmicdr Publiclbrl$ lMcidim. 0.rl rh.Ih Se.li0o.
l9l tatonalinitNtE tolin*oE trdar! oal tEfth ln
\w 2m. rrmrio hbbc 8:dth teh?'im.t al tlalh Wrm ,'asutq lttnwl
rtredcu PublicHealrh
lssisrion.0Bl HellthS€.tion.
l99?.oraltlerlth
Public!€alth
?000 ,{nedcan
rsod&d.Or4llt /4.l6drd.tirdd?(sinlr)
rnrricm PubUc
lkdrh
l99t Hulth 6nnMiti.\ 2lt)0:tt NUnatula/^ ltt iui't6lot @nnuni
^:\dilrim
afuiirndt
of
lx
2dn
tubtul
tuIb t)b|eh6 id d\ sohjnsroi. lC A.nnc,rnPublicHealrh
I
)w
35
dnr€ncor\blic trealthIsiation ty)1 .t Mtbtul b@lkpn\ttn Iol all aI lnawn Puhlk Hultt
^:llcrlthAvrirlion
Public
tsoaaftu, \ luyla tobe heltb wc ftlatu &btk \i tsldgton.Iii
^ne.icd
,\rmncmPuilKfkalri {s.ci&m t992anM j PuUnhaA npo/tahl l !a4-b-7a& qn/! n Acbatlb
,/t?y'lrr'r \6hingLn 0Ctmican PubLc
Herlti{vrirrm
,rssortioi of UiEnil inl ChildHealuPlogm l$l u.!tn!J tb .htlhny .1ftlnn on th. fi^t late pra
.i rr 0rE1 rq !6hin$on. Dadsrcidroro{nr|lnal Jndehh kdlh
iannM'ltargf,ritb|6ana
healtcar!rforn \la\hin8ron.
DC
.jss.ciirron
ol staklnd leditoridHerLrh
ofiichl5199.1
sratement.n
.\lsrtM d stxr4rd Tedtoriallkrlth o{icid5
Bo\rrll 1991.Inlergsnerrtional
advNaq Prpert|grnted ar0d neil$ rd\oc8 for lidigenrsorEn 3nd
\l II od \ Ltnq C0
chilftn erdforchlldpn$it]tqFd &dd c@ \ft{tr. IbblicHealrh
SediaReSions
PuUt Edtlb
8Mn JP.$!flosenJ!.\f t99t R4pral n'Iun6l.t ,ttt6tl .tnd.biu oal tu1ltt .lMiu
Pnga, (lsion \o 1100
dsidion
,'evn i )nnal tlevfing
t {x\hmFoi, !)c AnFicd PublkHe,lLh
8ud.rI. ! !M R l99l llindnv hdth is6
Declo^,tnual lleurl1,Lharkl@ SC
Pa{Epngnd d 0p Asiarion o{Su14
md Imldnal ltnlal
chn.Lry]{ t al helth aNit6lo
.billv lal ttc tw 2can:qlvtumtidld |thl| l8tltb lduh8
anddahh.,4ntua
LrNt E@ltblytstian Arr@lJldit! PnFLz (Sdioi \0 10{6J) \$ 1blkIl
!ftncan ruin lkrldr rsridion
Childr$s &feN iund.1989(qpr, a, 1989Nkaal bLl dnltl balltblel&l lqll4tt4n. Fahln,$nn.N.
co.brnsB l99l rid .l(l|) obi.tri6 Piperp@mtl at 0n] rk!10 foi \totFF ari ChildEnm Pubk flezlh
s€^1ceRc8'm\:
81ft?linforAdnD.Chicago.ll.
hntd lr'ciic P6muon.{dnrNtW Pn\46
nttaal a/tl htll|b .1a1a1 4a,dn6
OmknloroNe Conlml
rndPFsun Gokr ^tuanl
fd PFurrt 9nr6
ldnt^Cr
Dillenhee
I lyrl rindrngMUm rdccompli5hrh ra ]000onl hedlthobiectivcPr]*r pft!€ntd ar$e
\lc0n& clarleiron.SC
{sciltnn d Slare
ud TefiibrialDenlllDrRcroF.{nnu!l
Dilknhq.l l99l 0.rl hdJlthneeds
in Lh€d.rlopml ot |}mgrri6eFut
e'd
'fll1ftb oi
^sml
^{rxliE
ch dcn Pryerpnrnti d de Public
Heahh
S€rvia
R.8ion\1 \lorl6hotonoral lkrllh Arlil o)mponeol
Pdnm Hdh CG torUodeudd Chlldni.Da1l6.
fi
Peq pBnrn rltF Plbk derlhs€^'eRegroo
\r
Ddnr'1991Child
trrlh \ure^nrcn ll!lllrantu
{bftho?onodl lhaldr fild clmpmm dPnmd kd$ cn! for dne6dd ch'ldftn.Dillas.lX
^
lelDiqu6 b iMnplnh Lht1td l0l0 oBl hrdthobimns P.perpe
hrnrsdc8. Knno \t8 l99l Ptumolon
sld arthersardon d tu! rndltmiodrl Ilnral Dindo^Annual
lk rb& Clll.ron. yi.
.16
EnNislleB.SlEddaJ 1992.Deirrl healtidalacolle€tiotr
sing Behavio.rl
Riskfa.1orSuRillde SF1en.
AMkn PlUk Euhb Aeciatim Annuat @ng PnSnfl ls*jrn No ?0{}10).w6hjr$m, Dc:rmi@
FitEJ. 199?.
UFabonUdiaid lmiB ad z6
TeftitoridoenldDnEto6,sotbddqlz
ro&nlrl caE.PaptlptMEd rr tr A$ocirlion
forStaband
Ima q 1991.
fk lthyc0nnunid€s
zm: Ttrir clxtiontotlE )€a!20qJobietiE. PaF.p|genbdrl Public
fhrlth s€flia Regjon
U VorLrhAor ori.l tkrlih, Aqtal ftDponenroI Prinar HeallhCrlt for orheNmd
Cd{p PG.1990Ccning Nbi& lElplot 6al lptltlt An i.n PvUt EdIh },Nxizttt |tnr./l Metins
'm{) No Yo*.M: kFim PublicIrealrh
eoSu (s6ion No 1046
Aso.irrim.
C€orFR,JrbtourR.1991Pdid.r iryul foi ttr iq,It]{trnt ol odl lpalthorm f,E md childrR paltl pe
jn Pu}lictbalb seflie Regrm
!(Illd alonl tkzlnjfc Mo{6 mdchildren
i: EluErinlforktio& ftsgo, IL
CntrchR.l99l. Pmting a'a thotrd liusalio:l,e8zlcb.llo86 t slr&Mdiqid &trlll pmgmm.,lmizt
Ptqic Hsltb tstiat
lanulttedirS A?s',/4 (s6ion No.30{8) llanr4 ct ArmricmpublicHedth
ciffbuB S,SchmidR[. 1989,!r tt@lotr oI l!f'tu/6 atd 4dn&b .lLaad to bnd and 60l bsltt k tb
Dqadna, QlHaAbandEuw.tdtrtae 8e|lsda,MD:Richad
s.hmid^$oc..L1i
CJlmJq LouieR,ws'I SJl9E PtlmriE dentisllt]Panl-tbnEl ct6. Jturnal aJtu anteAanMatc.l
lvjztim 262:34!B-1461.
cn4 Jc,LouieR.Srofi SJ1990.
Ftrmtir &itslq: Prn II Peddontrldie.s6, rnrloccluriorl
raua a
611.,rxtt.kurvl ttb|Min
albd lflxi ian25t 42r 424.
tklpelD 1992lla io onl tleilthcetu M drikids ,lrd:an Pu icEqlb bn iann Amlal ttdinx
A!8zz (S€sion
N0.22U.3).
Vdltitrgdl Dc:
Publictkalh As.cidim
^dErican
flugh€s
D.1991oEl lE lh adre.l for0Enalen.l dd djld pqirlioi: MninislrrriEsrreSb. p.p€.ligr
d alonl lk l&Mvdrl fml.di8d vonenmd Childmad Io childllnwnhSpsiatl{czlhc4I{@&, tublic
}baft SenieRegio6UIi dd X.D€nwr.
C0
Huth6ICl99l l\ktee*ingtoa.cooplish
tE ]e& zmooralh€alt\obieciiB cc sludi€5
Il!|n mabmatari child
lp{Ih. Pryr plmEd aldErMialion 0iSlrl€andTeFitodal
Dentzl
Drct ishnual lkelin&Chaded.n,
Sc.
InEdmStudcoqr m D6rrl A.liviti6.l9E. tlpmin8 rtpoal heal$oiArcri@ FAle, qpoltnirv foracion:
Asludrofdr odl health..riviti€s
forttr lhdtu!
d fiealrhdi Hmd Serrc6.
L*m R.l99l. coundlinSooNcc€s
lo orrl tsll c@ foritdicaid@ipiqa (clar*s t{izs {rlifomia).paper
pubtic
p@lEd ar"t&l Me,c*iti€sl"r\Pl&nintvo*shop10Meal
the0rrl fk llh tied olMotm .rd chiHr€n.
fkzlit srFjc Rsgion
X Santrllri!.o, CA
37
P,rfHprw:.td
IsnarR l99l lnrplcNlocotMdisid L$rit( foi i& e l(fi denklpublkkrll pmgjz,as.
rz
,l tlx lNqltion fn tu& {d Temronal
Denbl0F.1n llnual \|iein& S.lx&lzle.
M,lxd sllltnHnpRnredh he.lrtnru kdLN oIl'sjiarricL)tnxru!{d Mxnco lr]eN
Jo{'lm D 1991.
oiDtiriqn {orChil&n Chic4o.lL
ed chil.
lohMn L l9ql childardfmi! rdvds Iitelstnle$ h dk deldopmol0{WSrm r'\in8 mo{ltcE
dEn Prixrp6.'rr€dd tubk ||alth S.nla Reson\ I \oftho! on0lrl Heal$:l\iril qxrpopnt o[ PrilM
Health
CrEforrto$e6{xl ChildFn.
l}rllit 1.|
PEr pIsLd
.lotmn ( ls9l. onl lM r d\l].6 lor tlk ma&md d'd chld f {rulaoon llgidatrE rrdLtF
onl lt.ihh,Adlocaq for lrNlgenl$mn dd ciuldM ed lof ChildFn
sldal lhdtlr Cr \i.rt. Pubhc
"nh
Heallhlflir Res.N \1ll trxl X.DcNr. C0
Johnenli ly)l Rdldio6 d a ch,ldhrld' d\ndt llaF.l)n*jntd,i 0.rl Il€rld rd!0cb-forlnlFnt \lopn
s.nia Repo,ri
\lrr mdt L)eiRr.c0
mdc])ild,tnrd forChildm$$ $nirl flcal$cm \d Puhlrc
Health
drdChdm in l,ubhcrhdd
Johnvrli ll)l Ttr ok o{ r dwcr. hpq pc€ntli alodl fkil$ {n 110{116
Chicato
lli6io teSionl]Blu€lnnrbr,c.non
h1e6R l99l onl rkald 1000Pqspnstnrdlr lll€,r\\ocidoniorSur md'ldilonrl D€nBlDftdofA.rual
Ka6 R lc9l oDl halft rmoInF$reo}t L{e.uN dtrrrm rqDn.oltlHnlk ztna.\ili ltlt Io€im:li D lq.ll l"Lvaxon,rioralherl$ nm fe&.i tualt\poln Pryr pNfld.l
Imond &nt-d{naro6 rnnorllledn& Chld61onSa
lheIsnlu
o{strk dd
IiulhlR l99l \t.ttmal bd child,)mlhrdthftst &$rrir por(rr.Pryr nrbenlld tin unuil m$lingoIthe
&ofirion Iu Sl1randTeFilonal
lxnril lttr(o6. idr\dale.lz
Ldh\Ni s ry)r Pohlicherlthxndonl trd$ dtendiua tt84-n89 .h6nz, /'!r/r Hdltb ttrlMttu,
,lm@l.tlding hqtun \9*ian \o r0l,l6r [xd'ingon.lC \rFnm Pubktkal$ {sociitroi
MNr l0 r99?1 ,Drrlr,4djl6 rr\t tng6
I S Dep&rftnlortleathMd HummS(^ic6
gnn on fldltht PttltL .ftn: udl tE ltb. \i$hldgtn N
llckdd'd ]v l99l AlFut\xr(nxl \etsxti for061llcallhkc8s l\rional \dM'* fo. 0fl1fledthk6.
Oal
leldtn l\l l99l Prnicipatinll
Ks6 in l{edcdd BuieF 1oeo:$ .lztk4n Publt fleltb ANralti4n,1rn@l
.tet ,( &D8raursNim \o l0l8).id4l.. (A rftncd PubLc
lkddr.\snr!m
:lationalCmkr
forfiuarion in llarrmaldd ftlld lkdlLhltl)l l9q Ru./ ltarl Hellt hdiluL: Pttfulin$
sahinF.n, D( \dm.l C61l!rforMaarhn in \tllefrrl mdOuLllhdh
\nioiil crmnri$ion
onchildftn jqi] Uenl tberhetui. \i!\ht|.g,oi.Ul tari0irl (bmnisiononChildlln
\4 10* smlcl\)air,ftnr ol llealthul thmld hbllc ndh l nNsin ofAlbmr.sl:tleI nntNl d \s lo*
s$rfl^rmronlld|tr.ldedDenlKd,lgdndtr.iuh
I l',91{lha . \'l
.i9
I
Norlo A{,DeCff q ftun n DY.192.tlerldrydildm E4dytokrrtr:rn es6nit coll'hontio tdw.n lE ldr
xAdttuie h.blic]Iab R4tt E W():3-15.
Nmt r, Ce6im
Ps,Johnei D0,MCtiguDJ,v.ldnr4 Ia. 1992Prdialiic0rrl fierlrl Vo*iry kler
96[ingtm, DCc,€orie
v6hirgtln Uni6ity, Cenrrfd tkzlh hic.etB€rntr.
offe d 6e SuBm csxBl. 1992.
PatenbM oc lu AMrz\ dil&en: R@ ol tb Stlpt
Ar{M
Eeltbr awt6 Rdr olaz. V6hjnSbo,Dc:06a d lh $uFor C€ml.
ht
ols
PniBz, rcnrq M8,S&mJII't lfz. Pu0inS
ladl i.t )!ulphFlcalF2minrit4 Pat l -{bilrtrh erd.d>
wx]a.hffit
oIFMitr Pdrr35:49 462.
P:rt 82,ftnn€yMB,StffeoselJDUl'lyr Putugr4dl i.to ]ulr phtiicdeninrrio
F.aiq Pladb 35:fl5-$l.
P:n 2 Jdula]b/rul o/
PtdMG,M.lirtdidr P([e.).1991Rtirtqud8i
c @ et
t9qwb@tttabtula'tddiUtuU
Ia@
@hc@. v*tngr4 DCN|ljmrl C6tr Ie [inElo ^:in Mrlcmdrd Chikt]zllh
Polltt tL 1992.
cdn .dim in c.litomia! Dati-&l pr%@ &Ki6
kn mNeM.r (ryi.€J.
PublktlealrhAsidim. oisl arl6
Publictkrlfi Stria R io L r99r.Tri-RqthalPu ic HuU bliz ,ulrnd od c&l o|al tuLb Ml6
a& h,bl$ Eelb*t"i@ R?]ttu 14 tn Eodoi,l{ Publkl*zlni sed.eR€sion
I.
hbtc rkaldl&niceRegjon
Il. l99r.fti Regtt4l htblicEellb S4ritzMbul aadcbtd6d tutb @nfel
M Pu ic ttaltb Sctrb ReSr^4 4 znr'z N* Yo{ M: Public
ltzlrh sdeieR!!m IL
tuhlk tkrlrtr S.rvialtegm n. r92. Pubk Eallh ktvi.e Regmrv wW
dlarrr. ,ll144 cA tublc rkd$ 5ri{ia Region
IV
@ 6d haA 4 t"otbl otd
tubk Hed$S€rvn€
RetiooL r99l.t d tuAb fu t&^
otd diLtd h h/b&: AaU brb
NlQtkt tr, adm. $l:gt tt:P\ icfl€?:hS€nice
R%imL
R4ri'. y:
Publiclret6 LTke Rqioir!1. 1991.
h/ll*: Itelb s.t"b Rqbn Wubtup M 6d tuA: A,tul @n4nnrn!
u.
EFtary tulb mlor aabn ard dilda. ttt\6.rrP|ttie ll.aJkltNia Redon
Publkrkddr S€flice
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nott ofpinary folh m jn nobnunr' d&ra. [arM Cily,Mo PublicrkdrhS€Mce
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SeivieRqim u vofthq onOal tkafth ,{ Vitd Grqm d Pimaq ttealrlC{Efd Mod6 ad chium,
0d16.Tx
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41
APPENDIXG
Sta.teSurn e! Follotoup
fftd|I|rit
of 3ttata3L. Dav.loD.d
n ncl| n ltoGd Wo.ldFf.
mdTenibnxlhntal DiNlors
PllpandforAssocialion
ofState
bv [alht Phipps,
Drlll, Execulivc
Pacific
AreaIlealth
Prepared
Director,orcgon
liucationftnFr
l3 I S\\ :0th,SuiteB.\erlx)n.0R 9:36i / Phone:
I / Fa\:i0J'.165'59a8
t0:]'165-&]l
In twductlon
In oder to rssistslal6 in integrrting
oril hcahhintomalemal
andchildhcalthpro'
gruns,thefublicHedthSenrce
Regional
0llic6 helda sen6of rgjonxl{orkhoF tocLr-\ing
$orl{shoF
wrsto pr(}
onnatemalandchildoralhealth.]'hepnmanpurl,ose
ol $es€1991
rj& lhenublicmd priYale
secto$
lnteftstdin health,rd humansenic€s
lo
lheopportuniN
develop
onl healthissues
collaborati\t
stntagl€s
and,qlon planslo addrcss
at thestateand
locallcvel.Theqrciiic goa[forthercgional
rorlrshop,s.
develotsd
b,vthenxtiondpl.rnong
()
(
polici€s
commillft.wre to I ) rlerelop
coalitro$ advocrie
for
to impronlheori heahhoi
motlEtsandcltldpn.(l) llrlta* asdene's
of oralhealthi$ues.(J) fomulaEa frane\ro*
fora state
aclionllan t0 nttt theorrl hcalthneetls
of motheri
andchildten,
and({) to
jncrca*publicaj)dprivaLcollaboralo0
oml
lo rcmor bame6t0
healthcart. In additional
plaminScon]mitleid$elopdBoals
tofi€scnalionslgoal5.
regional
clich refl€ckd
egional.
sl1te,andlocalis\uesThesc
rugionally
goalsfo.us€d
dewloped
onfourgenealissu€s:(1)
(:) slucition.prcmotion
nee&assessmenls.
advoca6.
coalitioN.
xndcollaboflion,(3)aceis
(9)
tosenicrsand rDlic\i
,rofuhops
of lheegional
wa\dc deYelopncni
md
Th€primary
outcom€
of st:rtegies
aationplans Sul€sin Regiotrs
L ll. fid III de\rloFdSmeml
slrute$plmsforfed€ral.
state.
llul€ theotherrtales
plans f_i\e
andlocalgoyemmen6
delelots{
nec specific
dominsnt
4-t
\r€reeli(hntin m(xtoftheplalsdotlopul.Ilree stntegie*trer (I ) d [t€ slaband
stnrtegies
should
h planned
and
localler€1.
andrundrdizrdnedsa-\*ssmen6
lracical,c&rdinat€d,
(3)
(2)
oral
heahh
issuei,
stale\r'ide
&alitions
should
be
deYelqxi
to
addrcis
imllemented.
prcmole
inclusion
of
srategi€s
areneeded
l0 increase
afoctlsonoialltalth rssuftand
multiple
({) rdomrsan necaasan
in polici€s
of
efecriYe
oralhealthcomponents
in poliqdenlopment,
uniielsxlaacess
to pdnuryofi heal$carc
th€healthmd humins€r,lioiqstemto ptuvid€
prtrcntive
andimlmwdefieafiitprcmotion
and
ando.aidissa\e
mersurcland(i) expanded
publicandlrcfession,rl
stafl.
dor[i aft nedd forlndrttregeneml
rdLrcation
Metbods
fie dentaldirKlo(oranallrcpriateI{CJ$rf ts$on.iorstatas
Dunng\lafiVApril199J.
andtlE Disuiclof Columbia
wrEinknie$rdbr phoneto erie* ttr slralr$plansderdoFd
wassuaw,6t0detemine
if i state
duringttEregional
mft\hops.'lhepuqxieoi theint€.view
of howimnlemenlation
rnimplemcnting
ihedarlopd stratsgi€s
andto olBin a senlP
c€ssful
looKplaff.
Xes4Es
*tle conducted
\rithfttrtsentatillsfn)m43strt6. 0f theae
stat€s.
one*asnot
lntenie.rs
lhestrategies
represented
at thewo*shopandsi\ hadmadenoprogrcss
in implemenlin8
hrauseofstafrtumover
ordismsrding
ofthesta€dentrllogranr.0f thermaining35slalej,
prcgHm
sEffdiFctingtheoral
irlile threehadnon+fllalprogram
t\!t of&nlzl
33hadsome
oftlE ltCHpn)grun.
he2.lhcomponcnt
24
somepmgrtss
loqad auiningfie sorhhopstr egies,
0f the35stdessln repoaed
\r€rccithercompletrd
or unde6r"!:Unfortunatehi
thisdo€s
€ponedthatall of lheirslralegles
withthesuale$:for in5l4nce,
man_v
states
nolmeznthalthevrcr€ neessarih,
succ€ssfill
Io imptur?
the$djcdd s$Em.eitherthn)ugh
incrces€s
in theltlricepopulalion
or
atFmlted
mdearcr.
eimbursement
raks,huttrryfe,r'wrpr.lually$rc€sfulatlhhnanicular
thestat€
hd.s{onthefivegeneral
stxlllgi€s
desadH
TableI categodz5
sl€aificslrategies
pnliouslr In rnns of needrassfssment,
Rlatingto ne(ds
18of theJ6stxles
hada sIraleg.f
slal€s
asfssment.
B€aause
some
hadmoe$an onestrles-'in thisara"thee*erc2l diffeent
\rrl! eitheroralheahh
slrategi€s
relalinB
to nee&a\r€ssnent.
ln thisca\€.n€rdrass€ssmenls
pruvider
praclice
andIedicridlanicipation.Forthisl&ticular
ilss€ssmenb
or dssei\menb
of
*rtl eilherconpleted
rvhilenoprogfi5s
hadb€enma&
bsue,ll of dF strategi€s
or under$r)_
onfourstntldes.
44
Table 1: Carqortzed StateWcilic S,ratqlcs
Cargor'
No.ofstzl6
No.ofstnltges
No.Coryletd orLh&flvay
N€edAssesmeot
I8
2l
$ar*id€C,oaliuorls
It
l5
oraltlealhIs$Es
m
RdolIDs
24
23
42
l7
l3
I9
35
l8
PMnotioo/Education 18
2l
Irisc.r.sston
In lhisinstence
thenumhrsfromthefollo*lp intrrvifl donotpmvi&trulym€aningful
inJormetion.
mlzrrercmaningful,hocEi€(uEresome
of dEdisausions
sith prcgraristxfi
prccess.
lhatdndd durinttlE intstvies,
In gen€ral
6e prcgrarn
st fl fel thattfu sod$hoF
{rr€ ltly hndicialil ardftis isa significanl
it cenainkE individuals
'&r€pltrent T1Ek€v
individuels
prominenr
i&ntifiedioclud€d
MCHpmgrrJnst ff, prf€rab! theMCIIdivision
chid,keyindividuals
fiomothersignificant
healthde?aft)€nt
n fl $tich malinclu&ptewn
litEor conrnunity
heal$seryio5,
sfongrcpG€ntation
from$e privare
&nlal sealota]ong
vnh keyindividuals
fiomadw(a'ygmuF. ThGestarsrio hada goodreF€senlarioo
ftom
thes€
keySroups
hadmor€success
in attaining
thekskategies.
Another
which
avenue
amealtdto besccesfulwastlE dftloprnentof a sltongcoalition
or adrisonboadvhich
couldh used
topmlnohth€inclusion
oforalhealthintogan€ral
MCfigograrlb.T16€shles
sith a broadbase
supl'onartheMCH
mdshoFoftenus€dthatgtoupasa bas€
fortheon8o,
ingoralhEJthcralitjon.
Altt|ouSh
nanysuEshalt hd suc.ess
in n€€tingilEir sfaregies
moccouldk doft to
irnprcrctlE integralon
of oralheallhintog€neral
maEmalandchildh€althpmgnns.One
sLledenLldircclor
erSgesled
thattlE 1991
*orkhoF hevi€'rtdasa gmundbreeling
s!ftstlq)ad thardditional\tDrt$boF
lEld
h
toconlinue
d|enerx,o*ing
prc.tss
ardcollabontiE
$fiichwasstaded.ManyMCHprcgflrndircatots
aretiFd of lFaringtlrcirnnonance
of oral
hedh fromtheirdeiui pograngafr.Having
anouN&authoril.v
bringin8
orallEaithisues
lo light appeand
tok animport nt sbpin E ducationpmce$.
45
APPETDTX
D
Mlb
IIe&b
Sentbe
Regtonal IWaI
Cottsulrafis
It tor mru lth dlioul i0fuodin d.nt ofdEctbn l mrt!h.F! pL.recoE
dr|iotrl otidtnth 6atregion.
f.ah. I
r.abr !
ntrtO lrrlu, DJ.s,l{Pl{
f.sind D.ndCo@'s'd
R.ginI
fr &Aarlhilding
Rm l{01
G@nC.alt
Bodo4
H |u20t
l&htr L@ DJ.S.
n({ioo.l ftnul Cc|3'h'nt
usms,ru, Mol
3535M.tid St!4 Rdrtrl0t{0
P0Bd 13716
lildl Sbp14
nr d+hi1 PA19104
2r1596l.5?ftFrzrr!46ffi
611
5n{,r'L6z
-*,r1t6t F,g:
UturAbq
D.D.&
R4hnrl lilol CdE|hmt
a.abr 2
usu{tr,Pls'Mot
M.rtd$r4 Rm l0ll0
3535
P0Eor13716
MrilSbpl{
thjH+hlr, PA19101
2r159645?f
tF.,:21 5*ffi
lnleolfDi|rD.DS.,
-PJ.
nAin llh|bl CEilrI
Blgbr ll
Divi{mdtLdfi RlrqlllesD*h?@alt
n@3337
6F&rlPid
Nrrbfi M I0?/8
2rL*Lr935
t Fa zt24+1321
lr|dlLXr!,R"DJI,
MJ.
lldgallblCon$lbol
f.Ebn II
Ilriin dll.h n lorrt sDedo?ctt
sd:337
6&rl Plor
Rrrb*, NY10478
fahr a
[dE, D.D.S,
Mrfi.
John
Rcfiond
DeotalcoN
t nl
0tlH$R€Srcr
Iv
Divt{md lt lh SertrsDdiray
$its 1202
l0l l{.rtf.lb*r
rdrntr GA30323
4tA3/3t
-52'l/ Eu. 4(*33r-?'16
zr2-*3r3sI F,of.
zt2-x,.t3z1
o
n atonI
rybn0
KadrlnlbdderM.D.,
M.PH.
Regonal
Prograrn
Consultant
I
DHHS
Regjon
lTthFloor
lot VeslMrnrsSt
Chicago,
It fi603
/ [ax:312-353{]18
312-353-llm
Reginald
lruie,D.D.S
, M.PII.
Regional
PlDgruIl
CoNullant
IX
DHHS
Regjon
Fe&raloffi.eBuilding"
Room
147
Plaza
t0 Ilnitadl{alions
sanfrancisco,
CA94102
4ltt56'fu33/ Fa\:4l15t63436
Rqtlon a
R.atoG lO
D.D.S.,
Robed
Sappinghfl
M.PH.
Regional
Dental
ConsulLnl
USDHHS.
PHS
Rmm1850
\lainTo.rer
Building
1200
D{Irs,TX7t202
2r+767-3719
/ Fax2l+167-8,J4,9
Wi[iam
VilliamlD.D.S..
M.PIl.
Regonal
thotd Consulrnt
IkpanmmtofHeal$andHuman
&rvicrs
Region
X
Divisioo
Services
Delftn
ofHealth
2201
fih AE MailsropL\-2'
|
&ade,Vashin$on
9812
2c66t'2& / F,d.:2tf_3tD-0
,157
i.ator t
LanvWalkelDD.S.
Region.l
hntal Consult
nt
Region
l1l
Nortd€mi offioeBuilding
Rmm501, tth tlmr Vest
iol Easll2lhStrett
xar$ ciq,M064106
8 1642629]16
/ r?d:81€42G1178
R.dfoo I
Ja!Eala(D.M.D..M.PH.
Regiona!
Denlrlconsultant
Region
Vtll PublicH€alfi&ffice
Fe&mlofliceBuilding
DiYision
Servic6
of Health
hlir€N
Rmm498
1961
StoutSt€€l
DenwrC080294
/ Fe-\:
l7
303'84i't955
i03-84461
48