Escambia Dental Cooperative

Summary of Current Program
The Escambia Dental Cooperative (EDC) is a collaborative community partnership of West Florida Area Health Education Center (AHEC), Pensacola Junior College and Sacred Heart Health System. The EDC is located in the PJC Warrington Dental Assisting Clinic, and administrative office 3117. Since February, 2006, this dental initiative has served adult clients, ages 19-64, from diverse populations in Escambia County, who require urgent dental care. The program’s focus is the provision of basic emergency dental services for patients under 200% of the federal poverty guidelines, who are without medical insurance, and who are not eligible for any other government assistance. This project is an outcome of the efforts of several community organizations in an endeavor to stem the tide of uninsured adults using local emergency departments and community primary care clinics for treatment of oral health problems. The goal of this program is to provide timely intervention and oral health delivery to the stated population in order to reduce impact on local emergency departments, community and faith-based clinics, and elevate the oral health care of Escambia County’s citizens. The Escambia Dental Cooperative provides dental care to eligible clients, once they are screened and referred for treatment.

Eligibility and Referral Sources
No appointments are made directly with the EDC. All patients must be financially screened and referred through our partnering organizations. Eligible clients are evaluated and treated on a referral-only basis from physicians and other practitioners at the following referral sites: Sacred Heart Emergency Department, Baptist Hospital Emergency Department, Escambia Community Clinic, and two faith-based clinics, St. Joseph’s Medical Clinic and Health and Hope Clinic. These facilities provide the majority of primary care for the uninsured in the community. Financial screenings and clinical screenings are performed on all patients before referral to the EDC. Best options for patients seeking referral to the clinic would be through Escambia Community Clinic, 2200 North Palafox St., or St. Joseph’s Medical Clinic at 131 West Intendencia Street. Patients should not be directed to utilize Emergency Room Services at any area hospital to gain referral to the EDC. Once a patient is deemed eligible for a referral to the EDC, the referring organization requests that an appointment be made for the patient through the schedulers at the Sacred Heart Call Center. A limited number of patients from Santa Rosa County are also seen at the clinic, and all Santa Rosa patients are referred through the Santa Rosa Community Clinic.

Agency and Community Roles in Community Dental Partnership
Key to the development of this program has been the support of several community organizations. Partners in the Escambia Dental Cooperative include Pensacola Junior College (PJC), West Florida AHEC, and Sacred Heart Health System, each providing both financial and institutional support for the program. Clinic partner West Florida AHEC leverages the resources of academic health centers and other educational institutions to improve access to health care services in medically underserved communities. Pensacola Junior College provides its Dental Assisting Clinic with four well-equipped operatories, panoramic x-ray equipment, office space, and lab area for use by the clinic. The Florida Department of Health, Escambia County Health Department, is acknowledged for its administration of the grant funds that were appropriated by the Florida Legislature for use in meeting the dental needs of the underserved population of the area.

Scope of Care
Procedures performed at the clinic include a range of services from dental extractions: treatment of dental infections, minor oral surgery, alveoplasty, oral evaluations and x-rays. Limited restorative work (fillings) is done, due to the great need for emergency extractions in the majority of referred patients, and lack of available dentists to provide additional care. No specialty dental care is provided at the clinic. EDC dentists refer patients who need additional medical attention to Escambia Community Clinic, the primary “medical home” in our county for the charity care patients, or the patient’s other primary care provider. This is necessary in many EDC patients who have chronic diseases such as diabetes and cardiovascular disease. Preventive and Dental Hygiene services are available in the PJC Dental Hygiene Clinic, and appropriate referrals are made during treatment at the EDC to that program at no cost to the patient.

EDC Staff
The EDC staff consists of Dr. Kathy Bosso, Ann Papadelias, Program Manager, and Dental Assistants Jennifer Kizer and Samantha Harris. Dr. Bosso has worked in private practice in our community for almost 25 years, and also works with the PJC Dental Hygiene program. Since February, 2006, the clinic has had Dr. Tony Chicola, Dr. Wes Sherouse, Dr. Andre LeBeau, and Dr. Kelly LeBeau, Dr. Buddy Lewis work as dentists, along with volunteer dentists Dr. Beau Biggs and Dr. Cecelia Hines.

Student Training/Clinical Contact Hours
This program utilizes the services of PJC Dental Assisting Program students, while providing them a required clinical rotation for completion of their certification. Contact hours are tracked for all Dental Assisting students working in the EDC for clinical rotations during spring semester. PJC Dental Hygiene Students are also afforded student training hours, as dental clinic patients are referred for dental hygiene services if the dentist determines need. Contact hours are tracked for all dental hygiene students treating EDC patients. Statistics are provided quarterly to West Florida AHEC.

Volunteer Dentist Contributions
Efforts have been made to gain volunteers from the EscaRosa Dental Society, with visits to several of the group’s monthly meetings to give updates on clinic operations. Currently, two volunteer dentist work with the EDC. All volunteer dentists are covered under the State of Florida Sovereign Immunity Program through the Volunteer Health Care Provider Program (VHCPP), and tracking and reporting is provided to the state each quarter.

Current Clinic Statistics and Tracking
The Clinic has been in operation since February, 2006. Due to availability of dentists and clinic space in the PJC Dental Assisting Clinic, clinic days have varied from one to three days per week since that time. Through the end of 2008, the EDC has provided more than 2,300 patient visits (either one visit or multiple visits per client) at an average of $500 in care for each patient visit, and a total of over $1.1 Million dollars in care to all patients. Seventy percent (70%) of these patients were new patient visits, 27% of patients returned for visits to continue a treatment plan of additional extractions, and 3% of patients were seen for post-operative visits.

The Escambia Dental Cooperative is a member of the Escambia Health Information Network (ESHIN). Patient demographic information, tracking of care and value of services provided is performed through CareScope, a software program which connects all referral partners (hospitals, clinics, and faith-based programs) through a secure computer network. Referral sites can access a record of dental care and clinic notes, as well as any medication prescribed through the CareScope program. Additional referrals to Case Management Services, Primary Care Services, AHEC Tobacco Cessation Programs, and other community resources can be made through the CareScope program and the Escambia Health Information Network (ESHIN). These referrals are tracked and monitored through the CareScope system.