Oral Health Advisory Board focuses on prevention education

Dr. Jim Crall of UCLA More LA Smiles (and friend) discussed public oral health campaigns during the final Oral Health Advisory Board meeting of 2020.

Representatives of the L.A.’s student oral health community met online December 15 at the fourth and final 2020 meeting of The L.A. Trust’s Oral Health Advisory Board.  

More than three dozen oral health providers and stakeholders attended the event, which focused on public health campaigns and best practices for student oral healthcare in the midst of the coronavirus pandemic. 

Maryjane Puffer, executive director of The Los Angeles Trust for Children’s Health, discussed The L.A. Trust’s oral health education campaign on KLCS featuring Program Manager Esther Yepez and her kid-friendly puppet, Billy. The campaign has generated up to 1.5 million views to date.  

Puffer thanked QueensCare for funding upcoming student oral healthcare education by The L.A. Trust at nine LAUSD sites and introduced The L.A. Trust’s new Oral Health Toolkit, providing useful resources for student and community dental care providers.  

Dr. Maritza Cabezas, dental director for L.A. County Department of Public Health, and Dr. Abrey Daniel, walked attendees through the development of a County oral health education campaign. She outlined the campaign development process, including: determining the need; selecting the audience; developing the message; and crafting the final creative with the help of focus groups. The County’s campaign’s goals are to increase awareness among caregivers of children under 5, demonstrating the importance and ease of at-home oral health habits.  

“People don’t understand the disease process when it comes to cavities – it’s insidious,” said Dr. Jim Crall, project director of UCLA More LA Smiles. He said “there are a lot of disconnects in oral health treatment” for children. Simple changes in student behavior can make a big difference and education is key. He previewed a series of TV spots featuring Sesame Street characters, which will be shown on KLCS remote learning channels through February. The L.A. Trust helped facilitate the broadcast of the Sesame Street spots.  

Doors still open 

Gloria Velasquez, organization facilitator for LAUSD Health and Human Services, said  seven Wellness Centers and school-based health clinics were still providing partial or full oral health services for students and community members: El Sereno Middle School (Western Dental); Hart Street Elementary School (Dr. Samoha); Jefferson Wellness Center (South Central Family Health Center); Maclay and Sun Valley Middle Schools (NEVHC); Monroe (Valley Community Health, appointment only); and Washington Prep Wellness Center (St. John’s Family and Wellness Center). 

Crall noted that the Medi-Cal Dental Transformation Initiative would continue but local DTI pilot programs would not. UCLA’s More LA Smiles LADRRS program (Los Angeles Dental Registry & Referral System) would be sustained for now and potentially integrated into the Department of Health Care Services.

Wellness Centers confer on impact and inclusion

Senior LAUSD Physician Dr. Rosina Franco provided an update on the District’s coronavirus response at The L.A. Trust Wellness Network Learning Collaborative.

Representatives from Los Angeles Unified and its Wellness Centers discussed how to reach and treat students during the COVID-19 pandemic at The L.A. Trust’s online Learning Collaborative October 14.

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Maryjane Puffer, executive director of The Los Angeles Trust for Children’s Health, welcomed the participants. Noting that inclusion was the theme of the gathering, she quoted Dr. Martin Luther King, Jr., who said, “Injustice anywhere is a threat to justice everywhere.”

Report card

Gloria Velasquez, an organization facilitator for L.A. Unified’s Student Health and Human Services, presented a Wellness Network Report Card for academic year 2019-2020. She reminded the attendees that the purpose of the Wellness Network was to help students and families “where there is a gap in healthcare” and thanked The L.A. Trust Data xChange “for gathering and presenting these metrics so they could be shared in so many different ways.”

Velasquez noted that student patients comprised more than 28% of all patients seen by the Wellness Clinics and they averaged 2.1 visits per year. More female than male students visited the clinics (55.6% vs. 44.4%) and the overwhelming number of student patients were teens 14-19. The top services provided to students were well child exams, overweight and obesity concerns, contraceptive management and vaccinations and pre-exposure prophylaxis (PrEP).

Return plan

Senior LAUSD Physician Dr. Rosina Franco provided an update on the District’s coronavirus response and prospects for school reopening. She noted that Los Angeles County was still in Tier 1, reflecting widespread case and positivity rates, and outlined the state’s requirements for re-opening. As of October 13, Los Angeles County had 9.0 new COVID cases per 100,000 population — the county’s positivity rate was 3.7% and rising.

Franco said L.A. Unified was laying the groundwork for a safe return to in-person instruction. LAUSD is currently testing teachers, staff and children in childcare to establish an initial COVID-19 baseline. The second phase of initial baseline testing will include all staff working from home. The third phase will include all students.

The District will do another return to school baseline test and periodic testing thereafter. Contacts of students and staff who test positive will be notified by the District as part of its robust Community Engagement effort.

Inclusive engagement

Two representatives from the Carson Wellness Center presented ideas on how to engage students and community members and drive visits to Wellness Centers.

Kristie Garrison of Healthy Start and Suzanne Markey of LAUSD School Mental Health offered marketing and communications tactics, including virtual clinic tours media to be shared on classroom Zoom meetings and social media. The team is focused on promoting clinic services to students, especially sexually transmitted infection and HIV prevention education.

Rosario Rico and Robert Renteria of The L.A. Trust gave a brief presentation on inclusive strategies to increase student use of LAUSD Wellness Centers.

They emphasized “location, location, location,” which includes virtual environments like Schoology, Zoom and social media, and more traditional methods like putting printed fliers in places where students are still checking in. They said messaging should include Wellness Center hours, available services, minor consent services and how to make an appointment.

The two-hour event concluded with breakout rooms discussing “How to expand outreach efforts in a more inclusive manner?” Suggestions included involving parents and past student clients as ambassadors; engaging teachers; and utilizing ConnectEd, Schoology and other platforms.

Conference attendees committed to exploring the techniques and increasing clinic visits next semester.

The L.A. Trust and its allies tackle student oral health

Beyond the Bell employees helped The L.A. Trust distribute more than 50,000 toothbrushes during Operation Tooth Fairy in June.

Oral health leaders from government, academia, nonprofits and the healthcare industry met online at The L.A. Trust’s Oral Health Advisory Board quarterly convening June 2. Representatives from more than a dozen organizations discussed ways to help students and their families access oral health services during the COVID-19 crisis.

Maryjane Puffer, executive director of The Los Angeles Trust for Children’s Health, presented an update on how the COVID-19 crisis was impacting dental care for students and communities. She outlined steps The L.A. Trust is taking during the current school closures, including the development of virtual education with upcoming videos, new referral cards for LAUSD local districts, and Operation Tooth Fairy, which raised oral health awareness and distributed more than 50,000 toothbrushes at 16 Grab and Go Food Centers in June.

Gloria E. Velasquez, organization facilitator for Los Angeles Unified’s Student Health and Human Services, outlined steps for re-opening LAUSD campuses under several models released by the Los Angeles County of Education. The models include face-to-face, distance and hybrid learning, depending on health conditions.

Budget cuts and telehealth

COVID-19 has had a major impact on state funding. Fatima Clark, senior policy and outreach associate for Children Now, noted there would be a staggering $54.3 billion budget deficit over the next two years. Among the budget changes: Delayed implementation of the CalAIM initiative; $300 million in cuts to Community Schools Grants; shift of $1.2 billion in Prop. 56 funds to support Medi-Cal; reduction of Adult Dental Benefit; and transitioning all Medi-Cal dental services to the fee-for-delivery system, eliminating voluntary dental managed care in L.A. County.

Dental care providers statewide are getting support from Sacramento as they grapple with COVID-19, according to a presentation by Stephanie Thornton, a fellow with the California Children’s Partnership. California has eased restrictions on telehealth, she noted, but the “digital divide” needs to be closed before these options can be accessed by everyone who needs them.

Ambitious agendas

Lisa Nguyen, associate director, community-based clinical education at the UCLA School of Dentistry, outlined what her institution is doing to advance school-based oral health, including updates on their assessment, education and outreach programs. Nguyen also provided an update on More LA Smiles and discussed the impact of COVID-19.

The meeting ended with a recap of a proposed 2020 policy agenda for The L.A. Trust’s Oral Health Advisory Board. The agenda includes achieving 100% compliance with the Kindergarten Oral Health Assessment Mandate throughout L.A. Unified; ensuring the highest standards of care and case management; integrating teledentistry and alternative practice providers; supporting robust funding for school-based oral health; creating a centralized resource repository; and promoting the use of fluoridated water by Los Angeles Unified families.