MAINE DONATED DENTAL SERVICES (DDS) PROGRAM Annual Report for July 1, 2011 - June 30, 2012 And

Fourth Quarter Activities for April 1, 2012 - June 30, 2012 Funded by the Oral Health Program, Division of Population Health, Maine Center for Disease Control and the Maine Dental Association Charitable Foundation Performance Snapshot
PatientsTreated
100

DonatedTreatment
97
$300,000

92

$309,758 $250,000

$200,000

50
$100,000

$0

Annual Goal

Actual

Annual Goal

Actual

Annual Activity Highlights Enabled 97 individuals with special needs to get $309,758 worth of care, exceeding the goal. Received additional funding to increase the Coordinators hours by eight hours per week, facilitating more care to more vulnerable individuals. Became members of the Maine Dental Access Coalition. Program History Many Maine residents with disabilities or who are elderly or medically fragile have serious dental problems because they cannot afford treatment. As a result of their ages or disabilities, many cannot work and depend on government assistance for their health care. Medicare, however, does not provide dental coverage and Maines Medicaid program provides limited dental benefits to adult recipients. Moreover, many dentists do not accept Medicaid. Other individuals with disabilities or who are aged or medically fragile and can work often earn too much to qualify for Medicaid, but not enough to afford dental insurance or costly dental care. As a result, many suffer in agonizing pain from serious dental problems and have nowhere to turn.

In 1999, the Maine Dental Association (MDA) and Dental Lifeline Network launched a statewide Donated Dental Services (DDS) program to help these people (the National Foundation of Dentistry for the Handicapped changed its name to Dental Lifeline Network in January 2011 and the local organization is now called Dental Lifeline Network Maine.). Since the programs inception, 981 vulnerable individuals have received $2,382,757 worth of free dental treatment from 159 dentists and 49 dental laboratories that volunteer statewide. Maines DDS program is similar to other programs developed by Dental Lifeline Network in 39 other states that collectively generated more than $24 million in donated care for nearly 7,400 individuals during the fiscal year that ended June 30, 2012.

The DDS Program in Action

Fifty-five-year-old Mr. L. lives in Fairfield with his wife and faces significant health challenges. He is in remission from Leukemia, is neutropenic, suffers from diabetes and arthritis and has seven stents in his heart. Sadly, aggressive arsenic treatment to fight the leukemia caused severe decay to his teeth. Moreover, 3 of his teeth were chipped and broken, two of which anchored his partial denture. Mr. L.s dental situation was very serious, as any infection could compromise his overall health. While Mr. L. desperately needed dental treatment, he simply could not afford it. He is unable to work and he and his wife survive on Social Security Disability benefits and help from a local food pantry. His health was in jeopardy and it seemed the treatment he truly needed was out of reach. Thankfully, Inland Hospital referred Mr. L. to the DDS program, and three generous volunteers came to his aid. An oral surgeon extracted nine teeth and a general dentist donated a full upper denture. A volunteer laboratory also helped by fabricating the denture at no charge. It seemed Mr. L. received treatment just in time. The oral surgeon discovered an infection that may have had grave consequences had it not been addressed. Thanks to this team of DDS volunteers, Mr. L. received $3,064 in free care that restored his oral health and helped preserve his overall health! He wrote to express his true appreciation for this lifechanging gift. I could never thank you enough for what you did for me. I am the luckiest man on earth. I have been through a lot in my life with the leukemia and the arsenic they treated me with. You and DDS took away the pain and anxiety I had with my teeth. You gave me more time with my family and life. Thank you so much.

Accomplishments This fiscal years goal was to help 92 individuals with disabilities or who are aged or medically fragile to access $250,000 worth of donated treatment. During the fiscal year, 97 patients received $309,758 in donated care, exceeding the goal! Each patient received an average of $3,193 worth of dental treatment; comprehensive care that illustrates the generosity of the volunteer dentists and labs. In addition to these 97 patients, 104 individuals had been referred to volunteer dentists and were receiving care at the end of the June 30th reporting period (i.e., active cases). A second goal was to provide $21,000 worth of donated lab services. Volunteer labs donated $33,200 worth of fabrications during the fiscal year, also exceeding the goal. We are so grateful for the generous contributions of the volunteer laboratories. Applications During the fiscal year, we received 114 applications, and 249 people were waiting to be referred to a dentist at the end of the fiscal year (the 249 people waiting reflects the applications received this year plus applicants from prior years who have still not been helped). 2

When the waiting list gets too long, the Coordinator must spend a significant amount of time responding to requests for applications and to subsequent questions from applicants; time that instead could be spent referring people to dentists and coordinating services. We continually monitor the waiting list and assess whether and where we are able to accept applications. Doing so helps the Coordinator process applications more efficiently so she has sufficient time to refer people to the volunteers. We inform the various human service agencies that refer applicants to the DDS program and ask them to help prioritize their clients needing care. Currently, we are accepting applications in Hancock, Piscataquis and Sagadahoc counties.

Staffing Ms. Ann Caron is the part-time DDS Coordinator and manages day-to-day services, working 24 hours a week (increased from 16 hours per week as of January 1st) from an office in Manchester generously donated by the Maine Dental Association (MDA). Ms. Caron determines applicant eligibility, links patients with nearby volunteer dentists, monitors each patients progress, arranges laboratory services and the help of specialists as necessary, and thanks the volunteers when they complete cases. Resolving problems that may interfere with care is, perhaps, her most important duty.

Leadership Council The Maine DDS Leadership Council helps ensure the continued success of the program. Dr. Michael Bufo chairs the Council that is comprised of volunteers from around the state as well as advisors from the Maine Dental Association. The Council members primary responsibilities are to serve as ambassadors for the DDS program and to recruit more volunteer dentists. Their work, along with support from the Maine Dental Association, has brought the total number of volunteers to 159 dentists statewide.

Volunteers The volunteers are the backbone of the DDS program, and we are truly grateful to the 159 dentists and 49 dental laboratories that volunteer. Twenty-eight percent of the dentists in the state dental association participate in DDS, compared with an average of 17 percent in other states with DDS programs.
State Dental Association Members who are DDS
30% 25% 20% 15% 10% 5% 0%

28%

Volunteers

17%

Maine

National Average

Of the 159 dentists, 50 are specialists, leaving only 109 general dentists for initial referrals. As the chart below indicates, applicants and dentists do not always align geographically, especially in the vast rural regions of the state. With 97 patients treated this fiscal year, 249 patients on our waiting list and 104 active cases, the dentists are well utilized, and as mentioned above, more are still needed.

General Dentists 69%

Specialists 31%

50

Pending Applicants vs. Volunteers by County

Volunteer Dentists Pending Applications

40

30

20

10

0
Cumbe rla nd Piscataqu is Fra nklin Som erset And rosco ggin Wa shingt on Pen obsc ot Ken nebec Sag adahoc Aroos took Hancock Li ncol n Wa ldo Kno x O xfor d Yor k

Consequently, recruitment is a priority. In September, we joined the Maine Dental Access Coalition and Ms. Caron attended the meeting and spoke about the DDS programs impact. In addition to ongoing efforts with the MDA including encouraging new member dentists to volunteer the Academy of General Dentistry (AGD) ran an advertisement in its publication to encourage its members to participate in DDS. Also, this fiscal year we began engaging larger, group dental practices and expect to see participation grow even further in the next fiscal year. In addition, we are exploring a partnership with the new dental school opening in Portland in 2014. Forty-nine dental laboratories also volunteer, but only 18 are located in Maine and most of these do not fully donate the fabricationsthey only offer discounts. To supplement, some lab services are coordinated through our national Dental Lifeline Network affiliate and 31 4

laboratories from other areas of the country help in Maine too. To increase the number of local volunteer labs and represent dental labs across Maine, Ms. Kathryn Young of Denture Designs joined the Maine DDS Leadership Council. Also, Ms. Young was instrumental in greatly reducing the wait list in Lincoln County by encouraging local dentists to participate in DDS.

Financial Information During the fiscal year, volunteers contributed $7.69 worth of care for every dollar spent!
$9 $8 $7 $6 $5 $4 $3 $2 $1 $0

Value of Dollars Spent to Donated Care

$7.69

$1

Dollars Spent

Donated Care

Though the dentists and many of the laboratories donate their services, we need to raise funds to support their volunteer efforts and pay for the part-time Coordinator, laboratory bills when we cannot find labs to donate, and other program expenses such as office supplies and postage. The State Oral Health Program has provided this needed funding that is then leveraged into thousands of dollars worth of contributed treatment. The Maine Dental Association Charitable Foundation provided a grant this year that allowed us to increase the Coordinators time by eight hours per week as of January 1, 2012. Northeast Delta Dental Foundation has also generously provided grants to supplement the state government support for some of the laboratory fabrications when we have needed more lab services than expected.

Future Plans In the next fiscal year July 1, 2012 to June 30, 2013 our goal is to help 92 people with disabilities or who are aged or medically at-risk receive at least $260,000 worth of free dental care, including $23,000 worth of donated laboratory fabrications.

Attachments We have attached a financial statement for the fiscal year along with a program services summary for the last four quarters. Also included are reports that show treatment provided by city and disability.

Maine Donated Dental Services (DDS) Program Fourth Quarter Report of Services April 1, 2012 June 30, 2012
FY12 1st Qtr. 7/11-9/11 85 26 0 21 FY12 2nd Qtr. 10/11-12/11 83 21 0 28 FY12 3rd Qtr. 1/12-3/12 99 46 0 24 FY12 4th Qtr. 4/12-6/12 104 45 0 35 FY12 TOTAL 104 1311 0 971

CATEGORY PATIENTS # of Active Cases # Referrals # Deceased or Otherwise Withdrew # of Patients Treated APPLICANTS # Received # Not Eligible # of Applications pending (as of 6/30/12) VOLUNTEERS # of Volunteer Dentists # involved with completed case # of Volunteer Labs # involved with completed case FINANCIAL Value of Care to Patients Treated Average Value of Treatment/Case Value of Donated Lab Services3 Value of Paid Lab Services Operating Costs Ratio/Donated Treatment per dollar of Operating Costs TOTAL SINCE START OF PROJECT Total Patients Treated Total Value of Care to Patients Treated
1

46 3 348

23 0 358

33 60 286

12 21 249

114 84 249

156 23 45 6

157 28 48 9

162 27 49 7

159 33 49 10

159 872 49 192

$49,932 $2,378 $5,485 $0 $8,454 $5.91 (1999) 981 $2,382,757

$82,227 $2,937 $7,846 ($1,398) $7,330 $11.22

$72,148 $3,006 $6,835 $323 $10,564 $6.83

$105,452 $3,013 $13,034 $630 $13,955 $7.56

$309,758 $3,193 $33,200 ($445) $40,303 $7.69

Total is less then the sum of the quarterly periods because it represents an unduplicated count of patients for the year, whereas some patients may have been counted in more than one quarter. 2 Total may be lower than sum of quarterly periods because some dentists and labs donate services to more than one patient during the year, while others donate only once. 3 Value also included in Value of Care to Patients Treated.

Printed 7/12/2012

Treatment by City
City
Albion Auburn Augusta Bangor Bath Berwick Biddeford Biddiford Blue Hill Bluehill Brooks Brunswick Camden Canton Cherryfield Chesterville Cushing Easton Eddington Fairfield Fryeburg Gardiner Gorham Gray Hancock Harrison Hartford

7/1/2011 Thru 7/1/2012

For Ann Caron

# of Transactions
1 2 4 4 3 1 2 1 1 1 1 3 1 1 2 1 1 2 1 2 1 2 2 4 1 1 2

Treatment Value
$1,700.00 $3,075.00 $9,310.00 $8,171.00 $6,627.00 $4,365.00 $10,115.00 $200.00 $1,700.00 $2,857.00 $811.00 $16,686.00 $2,460.00 $2,940.00 $1,245.00 $3,000.00 $2,982.00 $8,823.00 $922.00 $2,886.00 $307.00 $4,035.00 $890.00 $10,862.00 $3,619.00 $3,600.00 $3,694.00

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Treatment by City
City
Jackson Kittery Lebanon Leeds Lewiston Limerick Lincolnville Lisbon Madison Millinocket Monticello Moody Old Orchard Beach Orrington Portland Portsmouth Readfield Richmond Rockland Rockport Saco Sanford Scarbourogh Sidney So. China South China South Portland Stuben Topsham Troy

7/1/2011 Thru 7/1/2012

For Ann Caron

# of Transactions
2 1 1 1 4 2 1 2 1 1 1 1 1 1 10 1 1 1 7 1 4 1 2 1 2 1 1 2 3 1

Treatment Value
$7,835.00 $1,923.00 $5,905.00 $840.00 $6,410.00 $5,507.00 $145.00 $2,270.00 $4,788.00 $518.00 $1,750.00 $3,330.00 $3,278.00 $1,500.00 $19,533.00 $2,500.00 $2,110.00 $219.00 $11,066.00 $17,656.00 $11,339.00 $4,148.00 $1,209.00 $4,418.00 $6,076.00 $85.00 $5,500.00 $4,276.00 $15,799.00 $308.00

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Treatment by City
City
Unity Waldoboro Waterville Wells West Gardiner Windham Windsor Winslow Winthrop

7/1/2011 Thru 7/1/2012

For Ann Caron

# of Transactions
3 3 1 1 2 3 1 1 1

Treatment Value
$1,997.00 $5,111.00 $4,761.00 $2,265.00 $3,845.00 $11,214.00 $4,654.00 $1,394.00 $4,394.00

Summary
Total Patients Treated 97 Total Treatment $309,758.00

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Treatment by Disability
Disability
Acquired Immune Deficiency Brain Damage/Disorders/Diseases Cancer Circulatory Disorders Chronically Mentally Ill Developmental Disabilities or Delays Diabetes Elderly Epilepsy or Seizure Disorders Hearing Impaired/Deaf Heart Disease Auto-Immune Diseases Intestinal Disorders Kidney/Renal Diseases Muscle Disorders Neurological Disorders Obesity Orthopedic Disabilities Other Disorders/Disabilities/Diseases Respiratory Disorders Spinal Cord Injuries Visually Impaired/Blind

7/1/2011 Thru 7/1/2012

For Ann Caron

# of Transactions
2 4 13 5 8 4 1 2 2 1 13 3 3 17 2 3 3 10 23 2 1 1

Treatment Value
$9,206.00 $11,761.00 $34,351.00 $9,350.00 $29,459.00 $7,514.00 $3,005.00 $4,094.00 $872.00 $3,094.00 $28,346.00 $7,563.00 $3,082.00 $28,906.00 $5,636.00 $14,938.00 $7,413.00 $29,693.00 $55,152.00 $8,823.00 $5,000.00 $2,500.00

Summary
Total Patients Treated 97 Total Treatment $309,758.00

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