HRSA
awarded grants under its Special
Projects of National Significance
program to the applicants listed
below. Each abstract provides
both contact information and a
brief description of their project.
Lutheran
Medical Center
150 55th Street
Brooklyn, NY 11220
http://www.lmcmc.com/
This
four-part proposal seeks to create
partnerships between the Department
of Health and community health
centers in the U.S. Virgin Islands
and Lutheran Medical Center, a
Brooklyn, NY community and teaching
hospital, for the purpose of providing
preventive, restorative, and prosthetic
oral health services to underserved
HIV+/AIDS patients. Grant funds
will be used to re-equip four
dental treatment rooms in Year
1(plus two more in Year 2) and
to reestablish services at three
sites in St. Croix and on in St.
Thomas. A full-time dentist will
provide direct patient care and
supervise Lutheran Medical Center
residents assigned to these clinics.
The grantee anticipates an eight-month
lead time before services are
provided. Concurrent with this
effort, the grantee will create
a 40-hour distance learning curriculum
which will be marketed to dentists
nationwide to create a cadre of
oral health providers trained
to treat HIV+ persons. Also, research
effort will be mounted to evaluate
OraQuick, a too for diagnosing
HIV during routine dental examinations.
An extensive evaluation protocol
will be implemented for all aspects
of the program.
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Louisiana
State University
433 Bolivar Street
New
Orleans, LA 70112
The
HIV Outpatient Program of the
Medical Center of Louisiana at
New Orleans (MCLNO) has ten years
of "hands on" experience
in the provision of oral health
services to people living with
HIV/AIDS. Loss of healthcare facilities
due to hurricane Katrina offers
a unique opportunity to develop
and implement new and innovative
methods of delivering dental care,
using our extensive experience.
This project proposes the utilization
of a mobile dental unit traveling
between six community health center,
in two distinct phases. The first
year dental care will be provided
using a 'best practices"
model, during which time, data
concerning attitudes and beliefs
about oral health and wants and
need for care will be collected
from HIV positive clients. The
service delivery systems will
then be modified to accommodate
the input from consumers. A cost
analysis will then be performed
between the original HOP dental
clinic and the two phases of the
mobile dental unit. In addition
to providing oral health services
for HIV positive clients it is
proposed that "at risk"
individuals be brought into dental
care, where HIV testing will be
offered and linkage into the local
HIV continuum of care will occur.
The recent population shifts and
influx of migrant workers in New
Orleans has increased the need
for HIV testing in these "at
risk" populations.
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Montefiore
Medical Center
111 East 210th Street
Bronx, NY 10467
http://www.montefiore.org
Montefiore
Medical Center (MMC) proposes
to be an urban demonstration site
for the Oral Health Initiative.
The project will design and implement
an integrative model of dental
and medical primary care, integrate
a dental hygienist into an existing
HIV specialty team currently consisting
of a treatment educator, nutritionist,
pharmacist, and mental health
social worker, and deliver dental
services utilizing a mobile dental
unit.
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Special
Health Resources for Texas
2020 Bill Owens Parkway, Suite
230
Longview, TX 75604
http://www.shrt.net
The program proposes the establishment
of a partnership between the Texas
A&M University Baylor College
of Dentistry, SHRT and Meyers,
Villa & Associates. SHRT will
serve as the lead agent of the
project assuming responsibility
for administrative and programmatic
oversight. SHRT will also provide
dental/oral health education to
persons infected with HIV. The
education session will include
information on dental/oral health,
service availability and referral.
To monitor and track service delivery,
SHRT will recruit and hire a case
manager that will assist the client
retain dental/oral health care
services and collect appropriate
data.
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St.
Luke's-Roosevelt Hospital Center,
Center for Comprehensive Care
(CCC)
1111 Amsterdam Avenue at 114th
Street
New York NY 10025
http://www.centerforcare.org
The Center for Comprehensive Care
proposes to develop and evaluate
an innovative and replicable model
of care, "Keep Your Smile
Sharp" (KYSS), to provide
oral health care to HIV-positive,
underserved populations. Project
KYSS will be delivered at community-based
sites in four neighborhoods of
Manhattan in New York City that
have high rates of HIV seroprevalence
and inadequate dental health resources.
The program will offer the full
range of oral health services
currently provided by the CCC
at its two HIV outpatient clinics,
complemented by a program of community
education conducted in collaboration
with community organizations.
The program will reach HIV-positive
persons who do not currently access
oral health care or who access
care on an episodic basis only.
The target population may or may
not be receiving consistent HIV
primary care. Project KYSS will
link those who do not with HIV
outpatient care to insure that
program enrollees receive coordinated
HIV oral health and primary care.
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University
of Miami School of Medicine
1801 NW 9th Avenue, Suite 300
Miami, Florida 33136
http://www.med.miami.edu
The
overall goal of the Miami Dental
Access Program (MDAP) is to increase
access to oral health care services
for HIV-infected patients and
to decrease identified barriers.
Within this context, MDAP proposes
to develop, implement and evaluate
a new and innovative mobile dental
program for medically underserved
persons living with HIV in the
urban area of Miami-Dade County.
The program will emphasize prevention,
early intervention, and linkage
to comprehensive oral health care
for low income persons living
with HIV. MDAP will visit HIV
primary care clinics that do not
have on-site dental care in Miami-Dade
County and offer dental services
to patients who are being seen
on that day for HIV primary care
initial screenings. An innovative
aspect of this program is that
patients can receive oral health
services on the same day that
they receive HIV primary care.
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AIDS
Care Group
2304 Edgmont Avenue
Chester, PA 19013
The
AIDS Care Group of Chester City,
Delaware County, Pennsylvania
will establish a new satellite
dental office and target HIV positive
patients living in Chester, Lancaster,
and York Counties of Pennsylvania.
Access to dental care in these
counties is limited by insurance
status, poverty, disease stigma,
and lack of transportation. In
addressing these barriers, the
AIDS Care Group will initiate
a Demonstration Model of Oral
Health Care and collaborate with
current HIV/AIDS medical and services
providers to link their patients
into the project. Start-up activities
will include equipping a new one-chair
dental office in Coatesville,
Chester County; hiring a dentist
to work with the AIDS Care Group's
dentists; training auxiliary staff;
establishing transportation systems;
and developing evaluation measures.
Within four months, patients from
surrounding communities in Chester,
Lancaster, and York Counties will
have access to comprehensive oral
health care. The interventions
will include the use of evaluation
measures to help determine the
replicability of the project to
other high-need groups.
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AIDS
Resource Center of Wisconsin
445 South Adams Street
Green Bay, Wisconsin 54301
http://www.arcw.org
Summary
of Intervention: The AIDS Resource
Center of Wisconsin (ARCW) is
requesting a five-year, $1,757,467
Part V SPNS grant to extend dental
services into a 51-county rural
service area in greater Wisconsin,
an area in which no HIV dental
services are currently available.
ARCW's innovative hybrid model
of providing care includes the
establishment of an HIV Dental
Clinic in Green Bay the part of
the proposed service delivery
area that has the highest concentration
of HIV cases and the development
of an HIV Dental Reimbursement
Program for parts of the service
delivery area with lower concentrations
of HIV cases. ARCW projects that
the HIV Dental Reimbursement Program
will begin by October 2006 and
the HIV Dental Clinic in Green
Bay will open in February 2007.
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HIV
Alliance of Lane County
1966 Garden Avenue
Eugene, OR 97403
http://www.hivalliance.org
The
Community Health Centers of Lane
County, Lane Community College,
and the HIV Alliance have partnered
to provide reduced cost, comprehensive
oral health care to HIV patients
by conventional oral health care
providers in the region. Lane
Community College has a modern,
18 chair dental clinic that currently
is not fully used by the dental
programs. The Community Health
Center is an association of many
groups including the Lane HIV
Alliance. The Community Health
Center currently has an active,
school based prevention program,
but does not otherwise provide
comprehensive dental care. Dental
care for southern Oregon will
be provided in the Lane Community
College dental clinic in Eugene,
Oregon, which is readily accessible
from Interstate 5 and by frequent
Lane Transit District busses from
both Eugene and Springfield.
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Community
Health Center, Inc.
635 Main St.
Middletown, CT 06457
http://www.chc1.com
The Community Health Center, Inc.
proposes to bring new oral health
care services to the 400 low-income
HIV+ residents of Norwalk and
an approximate 200 HIV+ residents
from areas surrounding the city.
We will be providing 1 day of
dentistry and 1 day of hygiene
services at our new dental clinic
in Norwalk which will open in
December of 2006, and will render
an additional day of hygiene at
either the MidFairfield Project
AIDS Care or at our current site
at the Ben Franklin Head Start
(165 Flax Hill Rd). Until the
new clinic opens in December of
2006, 2 days of mobile dentistry
will be offered at our 165 Flax
Hill site. Key features of the
intervention include: referral
coordination services, a comprehensive
continuum of oral health services
which include: restorative, diagnostic,
preventive, periodontal, prosthodontic,
endodontic, oral medications,
oral surgery, emergency care and
oral health education/health promotion,
24-hour emergency care, and health
education/ promotion onsite at
our full-service clinic. CHC will
also employ a driver one day per
week to bring patients who lack
reliable transportation (the majority
of our target population) directly
to our clinic.
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University
of North Carolina at Chapel Hill
104 Airport Drive
Chapel Hill, NC 27599-1350
This
project seeks to establish a collaborative
group of investigators to conduct
a multidisciplinary oral health
program to address the dental
needs of newly diagnosed HIV positive
individuals from the Research
Triangle/Piedmont regions of North
Carolina. The oral health of these
newly diagnosed patients will
be compared to that of HIV positive
individuals who already receive
their routine dental care at the
UNC Hospitals dental clinic A
comparison will be made between
these two groups at all levels
to assess the impact of initiation
of oral health care in the HIV
population early rather than in
the midst of medical treatment
or emergently.
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Harbor
Health Services, Inc.
398 Neponset Avenue
Dorchester Massachusetts 02122
Harbor
Health Services, Inc. (HHSI) has
designed an HIV Oral Health Collaborative
model to increase accessibility
and affordability of dental services
for people living with HIV/AIDS
(PLWHA) on Cape Cod. HHSI will
create a new dental site in the
Outer Cape in collaboration with
Outer Cape Health Services and
will expand existing services
at its two community dental sites
located in the Mid and Lower Cape.
The dental clinics will use a
collaborative model of care where
patients are referred by partner
agencies to the dental clinics
and dental case managers will
coordinate dental services, follow
up with referring agency on visit
outcomes and ensure that patients
are linked to primary care and
social services. HHSI currently
partners with Cape Cod Healthcare-Infectious
Disease Clinical Services, a Title
III grantee around dental and
primary care services. The delivery
of services at HHSI current dental
sites, the Ellen Jones Community
Dental Center (EJCDC) in Harwich
and the Mid/Upper Cape Community
Health Center (MUCCHC) in Hyannis,
will begin in project year I.
Planning and development of the
new dental site in the Outer Cape
will begin in project year I,
with services anticipated to start
in project year II.
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The
Native American Health Center,
San Francisco
160 Capp Street
San Francisco, CA 941
http://www.nativehealth.org
The Native American Health Center's
HIV+ Oral health Program and Evaluation
(HOPE) Project will revolve around
establishing NAHC as the "dental
home" for the HIV+ San Franciscans
of color with pipelines back into
the community for specialty dental
care. The "dental home"
will stress 3 core components:
dental case management, dental
services on-site (including prevention
of oral disease and maintenance
of oral health), and specialty
dental services off-site in Partner
Specialty Dentists' (PSD) offices.
The HOPE Project's innovative
interventions include dental case
management and broadening the
dental safety net via partnerships
with private-practice specialists.
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Sandhills
Medical Foundation, Inc.
P. O. Box 366
McBee, SC 29101
http://www.sandhillsmedicalfoundation.com
Sandhills
Medical Foundation (SMF) proposes
to implement Project Save Our
Smiles (SOS), an innovative service
delivery model to provide oral
health care to persons living
with HIV/AIDS (PLWH/A) in a rural,
six-county region. In response
to these needs, SMF will lease/purchase
a mobile oral health unit with
two operatories, and staff this
with a specially-trained team
including a dentist, dental hygienist,
and dental assistant. The mobile
unit will visit seven rural community
health center sites on a scheduled
basis. Staff at these sites will
schedule their patients with HIV/AIDS
for oral health care visits. The
program will provide oral health
care services including restorative,
diagnostic, preventive, periodontic,
prosthodontic, endodontic, oral
medications, oral surgery, emergency
care and oral health education/health
promotion. Oral health services
will be provided in accordance
with professional practice guidelines.
Individualized treatment plans
will be developed for each patient
receiving service. Further, the
dental program will serve as an
entry point into HIV medical care
as it will refer to the Ryan White
Title III Programs participating
in Project SOS when it identifies
patients who may need HIV testing
or services. As many of those
identified with HIV are not in
medical care, dental care may
be a reasonable access route.
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Tenderloin
Health
183-191 Golden Gate Ave.
San Francisco, CA 94102
http://www.tlhealth.org
The
project is a collaboration of
the Tenderloin Health, San Francisco
Department of Public Health Tom
Waddell Health Center (TWHC) &
Dental Services, Asian & Pacific
Islander Wellness Center, and
Positive Resource Center. These
partners will provide comprehensive
oral health services incorporating
the following key elements: a)
Co-Location of Services: Dental
clinics will be located at TARC
and TWHC, existing providers of
HIV services. b) Integration of
Oral Health Care into Existing
Multidisciplinary Program will
result in seamless access to care.
c) Case Management and Peer Advocacy
will increase access and patient
adherence to treatment. d) Referral
& Coordination for Specialty
Services: While most dental services
will be provided at TARC and TWHC,
a formal referral process and
patient accompaniment will ensure
access to specialty services off-site.
e) Cultural Competency & HIV
Care Training for Oral Health
Staff will ensure that oral health
staff can work skillfully, sensitively
and in a culturally competent
manner with the target population.
f) Training of Non-Oral Health
Staff will ensure all team members
understand the critical importance
of oral health in the provision
of HIV care. g) Outreach, Patient
Education & Early Intervention
will ensure patient engagement,
increased receptivity to care,
and participation in their oral
care. h) Benefits Eligibility
Screening will mean patients can
document a disability that is
a result of an oral health problem.
i) Developing Systems of Reimbursement
to Ensure Program Sustainability:
The project will implement multiple
approaches to ensure program sustainability,
including maximizing third-party
reimbursement, primarily Medi-Cal.
j) Continuous Quality Improvement:
Oral health services will be integrated
into an existing system designed
to monitor the quality of services.
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