Oral Health Initiative

Oral health disease disproportionately affects children, persons with disabilities, elderly, low-income individuals, individuals in rural communities, and people of color. Oral healthcare has historically not received the same level of priority as other healthcare fields. However, when various focus groups are asked to identify their top health priorities, dental care and dental services is consistently among the highest. The barriers to obtaining dental care and promoting good oral healthcare include lack of access to dental insurance, insufficient reimbursement for publicly-funded dental care, an inadequate dental safety net, mal-distribution of dentists in certain communities, a less ethnically representative dentist workforce, current practice model for dentistry, and cultural values and practices regarding dental care. Oral healthcare remains one of the greatest unmet needs in the healthcare system.

California is not meeting the oral health needs of its residents as evidenced by the following:

• In Oral Health America's 2003 Oral Health Report Card, California received an overall "C" grade in advancing oral health and oral healthcare for its residents.
• An estimated 1.15 million (28%) residents lack dental coverage in TSFF's five-county region (Alameda, Contra Costa, Marin, San Francisco, and San Mateo Counties), more than double the number of residents who lack healthcare coverage. Of those without dental coverage, 52% (600,000) reported not being able to afford dental care when needed.
• Many children and adults with publicly financed dental coverage face difficulty accessing care. Few dentists will accept their insurance due to the inadequate reimbursement rates.

TSFF's five-county service area is home to 20 self-identified Dental Health Professional Shortage Areas. Residents in these communities regularly face tremendous barriers to access due to the mal-distribution of dentists and dental professionals.

Download a copy of the Foundation's Oral Health Briefing paper. (PDF)

Our Work
The three-year Oral Health Initiative: Enhancing Prevention, Access, and Community Partnerships (OHI) is designed to improve community-based opportunities for low-income Bay Area residents (uninsured and those with publicly financed dental coverage) to access dental services, both prevention and treatment programs. The Initiative also aims to identify and advocate for policy, regulatory, and/or legislative changes that are needed to reduce barriers to oral health services. As a community foundation attentive to the health needs of the communities it serves, we are committed to working with communities and investing resources in the oral health needs of residents in Alameda, Contra Costa, Marin, San Francisco, and San Mateo Counties.

Through the OHI, TSFF seeks to achieve the following objectives:

• Service Expansion: Address unmet oral health needs through expanded access (both prevention and treatment options).
• Delivery System: Create a more responsive system of care for oral health by enhancing delivery options and increasing care coordination among oral health and general health.
• Advocacy and System Reform: Address systemic barriers in the delivery and financing of oral health services through advocacy and policy.
• Education and Communication: Increase understanding and recognition of the importance of oral health among consumers, the general public, and policy makers.

The OHI consists of four interrelated components: (1) grantmaking, (2) policy formation and advocacy, (3) public education and strategic communications, and (4) evaluation.

OHI Grantees
The following organizations have been awarded grants under the Initiative:

• Alameda County Public Health Department - $105,000/3 years to link low-income uninsured children aged 0-5 to dental services through outreach, case management, and recruitment and training of dentists
• Alameda Health Consortium - $25,000/1 year to undertake a planning process designed to identify a common dental practice management system for eight community-based health centers
• California Dental Association Foundation - $105,000/3 years to build a model of care for oral health services provided to elderly residents of long-term care institutions
• Contra Costa Health Services - $120,000/3 years to increase the number of low-income children receiving dental services through service coordination, case management, mobile dental services, and improved provider participation
• Marin County Department of Health and Human Services - $90,000/3 years to implement the Marin County Oral Health Coordination Project, which will provide overall coordination of oral health programs serving underserved populations
• Native American Health Center - $120,000/3 years to provide oral health education/promotion and access, and improve provider training through the San Francisco Kids and Infant Oral Care Program
• San Mateo Medical Center - $25,000/6 months to undertake a planning effort related to the provision of dental services to pregnant Medi-Cal recipients
• University of the Pacific - $90,000/3 years to engage in policy and advocacy activities focused on the oral health needs of people with special needs and the elderly

Download a more complete description of the funded projects. (PDF)

Advisory Committee
The Advisory Committee provides advisory review on matters related to the planning and implementation of the Initiative. It also provides strategic guidance on the Initiative's priority areas, public policy and advocacy, public education and strategic communications, and evaluation. The Advisory Committee enhances TSFF's ability to communicate with and better serve the community during the life of the Initiative. The Advisory Committee consists of individuals in the oral health and health fields that are knowledgeable about the needs of the low-income persons with limited access to oral health services. Download a listing of Advisory Committee members. (PDF)

For more information about the Initiative or to learn, support, or partner with us, please contact the Foundation's Community Health Program staff at 415.733.8500.