“Federal Funding for Oral Health:
The Financial Model for
Federally Qualified Health Centers (FQHCs).”
Successful Models of Partnership Between
Schools and Health Centers
54th Annual ADEA Dean’s Conference
November 12, 2012
Rick Mumford, DMD, MPH
Clinical Associate Professor
Director of DISC Program
UNC-School of Dentistry
Department of Dental Ecology
Our primary partners – NC
AHECs & NCCHCA
Extramural Clinical Rotation’s Role in
Community – Based Clinical Dental Education
UNC - SOD and Community Health Centers
Dentistry In Service to Community –
(DISC) Program
Extramural Clinical Rotation’s Role in
Community – Based Clinical Dental Education
UNC - SOD and Community Health Centers
How we make the program work - How the parts
work together to achieve our respective missions
UNC – SOD DISC – Community-based
Extramural Clinical Programs:
An Educational Mission
Dentistry In Service To Communities
•DDS Students Summer 3rd Year clinical rotations – required (8 weeks)
•DDS Students All other clinical additional rotations
•Student Health Action Coalition (SHAC) - Volunteer student clinic
entering its fourth decade.
•DH Student practicums – required (3 weeks) many NC communities
•International Projects – Students learn a global perspective of service
•ENNEAD Student Volunteers – NC Public Schools, NCDS-MOM
clinics and community health fairs
•Student Organizations – such as “Sealant Saturdays” Greene County
Notes: A full-time faculty or adjunct is required onsite as attending and preceptor for clinical
activities. These are volunteer, non-paid adjuncts.
UNC-CH partners with NC AHEC to provide AHEC housing during required clinical rotations
UNC - SOD Extramural rotations - 4th Year Students
Dentistry in Service to Communities – DISC Program
DISC PROGRAM GOALS
The DISC IV extramural program has two primary goals:
•To give students an opportunity to observe and participate in a
variety of oral health care delivery systems – public dental practices
while providing clinical care
•To expose students to a diverse patient population, including those
with special needs – which students would be unlikely to encounter in
the dental school clinic - but which are represented in communities
where dentistry is practiced (two 4-week rotations required; one - a
public dental practice and one – a hospital rotation)
Note: With course director permission, two general practice rotations
are permitted
UNC-SOD DISC Students – Clinical Credit Received
Currently four departments allow clinical credit for some
procedures completed on extramural rotations:
• OMFS allows up to 20 extractions
• Prosthodontics allows 2 full sets of dentures
• Pediatric Dentistry allows credit for child patients seen in
pre-approved sites with boarded pedodontists
• Diagnostic Sciences & General Dentistry
Allows credit for biopsy submission
Our primary partners – NC
AHECs & NCCHCA
Extramural Clinical Rotation’s Role in:
Community – Based Clinical Dental Education UNC - SOD and NC AHEC: A training mission
http://www.ncahec.net/
8
NC AHEC Regions
DISC Sites by
AHEC Region
Our primary partners – NC
AHECs & NCCHCA
Extramural Clinical Rotation’s Role in:
Community – Based Clinical Dental Education
UNC - SOD and NC CHC: A healthcare access mission
http://www.ncchca.org/
12
Dentistry In Service to Community –
(DISC) Program
DISC Rotations 2011 – Total (156)
115 Student Rotations in NC - 74%
41 Student Rotations U.S. other or international – 26%
NC Counties served Summer 2011 Total students
78
Alamance
Chatham
Cumberland
Durham
Forsyth
Burke
Gaston
Buncombe
Greene
Catawba
Granville
Robeson
Guilford
Wayne
Orange
Wilkes
New Hanover
Jones
Mecklenburg
Edgecombe
Orange
Moore
Person
Haywood
Pitt
Lincoln
Sampson
Stanley
Rowan
Wake
Wayne
(Represents 66 active sites)
DISC Rotation Sites in North Carolina by County
Ashe
Alleghany
Surry
Stokes
Person
Caswell
Rockingham
Vance
Watauga
Mitchell
Wilkes
15
Avery
Yadkin
Yancey
McDowell
14
Haywood
Chatham
Polk
Cleveland
Gaston
Transylvania
Stanly
17
5
Lenoir
16
Richmond
Hoke
Tyrrell
Beaufort
Greene
Craven
Pamlico
7
Clay
Washington
Wayne
13
Harnett
Moore
Montgomery
Mecklenburg
Union
10Martin
Pitt
Johnston
Lee
4
Cabarrus
Cumberland
Jones
Sampson
Anson
Duplin
Scotland
Carteret
6Onslow
Robeson
Bladen
Pender
42 Blue Counties indicate
presence of DISC Sites
Currituck
Wilson
Rowan
Rutherford
Henderson
Jackson
Macon
Cherokee
Catawba
Edgecombe
12
Lincoln
Swain
Nash
Wake
Randolph
Camden
Pasquotank
Bertie
Franklin
11
Davidson
Iredell
Hertford
Halifax
Davie
Alexander
Burke
Graham
1
Alamance Orange Durham
Guilford
9
Caldwell
Madison
2
Buncombe
8
Forsyth
Gates
Northampton
Warren
Granville
New
Columbus
3Hanover
Brunswick
66 Active NC DISC Sites
10/19/12
Hyde
Dare
Dentistry In Service to Community –
(DISC) Program
Community Health Centers - 2012
Outside NC:
Colorado - Peak Vista CHC
Georgia - Good Samaritan - Atlanta
Maine - Penobscot CHS
(some others less often)
Key Program Costs $:
•Staffing – 2 FTEs (1-Faculty, 1- Staff)
•Student Stipend (Inside NC ↑ 35 miles)
•Housing (Inside NC ↑ 35 miles)
•Preceptor Annual C.E. Event
•Travel (New sites, Troubleshooting)
•Misc.
Cost Estimates $:
•Staffing = ~ $250,000
•Student Stipend = ~ $18,000
•Housing = ~ $6,000 ($5.00/night)
•Preceptor Annual C.E. Event = ~ $5,000
•Travel = ~ $3,000
•Misc. = ~ $5,000
Approx. $287,000 to $290,000/yr
Funding Sources $:
•Staffing – 2 FTEs – AHEC (state funds)
•Student Stipend - AHEC (state funds)
•Housing - SoD (state funds/Dean’s Acct.)
•Preceptor Annual C.E. Event – (Dean’s Acct.)
•Travel - AHEC (state funds) or Dent Foundation
•Misc. - Dent Foundation
+
“In-Kind Cost of Preceptors & Clinics”
Funding Sources $ Free Advice:
Find Partners with state funding and solid network of
advocates & an inter-professional mission
Maximize use of “in-kind” resources (Existing clinics
and dental staffs)
Incentives to partners:
Community service reports to AHEC
Waive fee to post job openings
Reduced rate or free C.E. to preceptors
Adjunct faculty appointments (CV help)
Electronic use of health sciences libraries
Student stores discount
Grant letters of support
Reciprocate
UNC – SOD DISC
Program Highlight
AHEC Annual Report—School of Dentistry 2010-2011
1 October 2011
Using the UNC School of Dentistry's Dental Faculty
Practice fee schedule, as it more closely reflects the cost
assumed by patients at private practices, the students
provided $1,302,938 in dental services to underserved
populations in North Carolina.
UNC – SOD: Dentistry In Service to Communities Program
DISC + CHCs & AHECs = a successful partnership
Serving North Carolina “safety net” dental clinics and helping to
expand access to oral health care across the the state for over 20
years!
Rick Mumford, DMD, MPH
Director, DISC Program
UNC at Chapel Hill - School of Dentistry
Campus Box # 7450
Chapel Hill, NC 27599-7450
rick_mumford@dentistry.unc.edu
T - 919.966.2787
F - 919.843.1170
Thank you – Questions?
Sukriya
Xièxiè nǐ!
Спасибо
Merci