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Strengthen the capacity of the safety net and community to provide high quality, integrated care for consumers with no or inadequate health insurance coverage.
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Grantee Story – Cass County Dental Clinic

The exam rooms at the Cass County Dental Clinic in Belton, MO, are humming with activity, even in this COVID-19 pandemic time. The clinic was forced to shut down patient care for eight weeks at the start of the pandemic, but as the dental team figured out how to adjust with the health crisis, appointment scheduling, school referrals and coordinating specialist care eventually approached nearly pre-pandemic levels. Patient and staff safety were the first priorities, but everyone on the team understood the importance of getting “back to some semblance of normal.” The clinic is a Medicaid dental provider for children in the county, serving thousands of children who otherwise would have limited options for oral health care.

The Cass County Dental Clinic got its start a little more than a decade ago as a bold idea conceived by a coalition of dentists, nurses, educators, business leaders and other community members who were determined to find a sustainable solution for children to receive dental care. The coalition met for nearly two years to construct a plan for financing and operating a children’s dental clinic willing to accept Medicaid patients, said Cynthia Randazzo, president and CEO of the Cass Community Health Foundation, which manages the dental clinic. Randazzo, who was an original member of the coalition and previously led the Cass Community Health Foundation’s volunteer Dental Care for Children Program, said the evidence of need and urgent requests for help with dental treatment from area school district nurses, motivated the coalition to build and launch a plan for a self-sustaining dental clinic.

“We would come away from school-based oral health screenings with more than 30% of children requiring immediate dental care and no way to meet the demand,” Randazzo said. Initially, about 20% of children screened had active rampant caries, a condition characterized by rapidly growing cavities in multiple teeth, which in children frequently requires treatment in medical facilities.

“Those situations kept the community motivated to find a solution for our children. Once we opened our doors, the area school district leaders were some of our strongest supporters and promoters of our services.”

Randazzo said she is amazed at the impact of the coalition’s early work. The Belton location opened in 2011 and a second clinic site in Harrisonville in 2015, which increased access by 52% in the southern half of the county. She said transportation has been a barrier to access in the largely rural county. Opening the Harrisonville site improved access in the southern part of the county, moving the clinic closer toward its goal of being a “dental home” for children.

Cass Regional Medical Center provided the Cass Community Health Foundation $100,000 in seed money and donated space in an unoccupied medical office building in Harrisonville. The Medical Center continues to donate the space and provide building maintenance. That partnership allowed the dental clinic to use grants and other donated funds to remodel and equip the clinic. Core operating grants from REACH, as well as other general support and capacity building grants, have supported general operations, school-based screening and program capacity studies.

Katie Schroeder, Director of Dental Programs, said the clinic sites have developed a strong focus on oral health prevention. Schroeder said every dental visit involves education on dental health, both for children and their parents/guardians. “That means talking about brushing and flossing, avoiding sugary drinks, and educating parents on early childhood caries.” The clinic also conducts oral health screenings in 11 school districts, reaching nearly 5,000 children a year. The screenings are key to identifying oral health concerns early and reinforcing preventive care.

In 2020, REACH awarded the Cass Community Foundation $50,000 in core operating support and an additional $50,000 in COVID-19 Emergency Assistance funding. The clinic has received 33 grants totaling $1.1 million since 2010.
Over 10 years, the Cass County Dental Clinic has provided 51,500 encounters.

Randazzo said the hiring of a patient care coordinator in 2013 has been key to productivity and patient outcomes. “Our goal is that 75% or more of children complete their treatment plans within 12 months. Our patient care coordinator calls families for appointment scheduling and reminders; helps with referrals for children who need treatment within a medical setting because of rampant caries; and works with specialists to arrange treatment for children with other complex needs,” Randazzo said.

In 2019, REACH awarded the Cass Community Health Foundation a $30,000 grant to develop a feasibility plan and train providers for a teledentistry pilot program. Other funding came through the Missouri Department of Health and Senior Services and Delta Dental Foundation of Missouri to support mobile equipment and other needs. The pilot program was implemented in two school districts in 2020, and is slated to expand in 2021. While still in the early stages, Randazzo said the pilot has been effective in reaching children who were not receiving dental care.

“The impact the Cass County Dental Clinic has had in our county is remarkable – we’ve served thousands of children, helping them achieve better oral health, and live and learn pain free,” said Randazzo. “We’ve reduced our percent of rampant caries from 20-25% to 14% and formed important partnerships with health care, education and other community groups that have jumped in to help us grow and expand this program for the benefit of Cass County – a true collaborative effort.”

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