COUNTY OF SAN MATEO

Inter-Departmental Correspondence

Health Services Agency

DATE:

March 15, 2002

BOARD MEETING DATE:

April 2, 2002

TO:

Honorable Board of Supervisors

FROM:

Charlene Silva, Interim Director of Health Services

Brian Zamora, Director of Public Health and Environmental Protection

SUBJECT:

Agreement with the State of California Department of Health Services for the Dental Disease Prevention Program

Recommendation

Adopt a resolution authorizing the President of the Board to execute an agreement with the State of California Department of Health Services for the Dental Disease Prevention Program.

Background

In San Mateo County, the most common health problem identified in low-income children who receive exams through the Child Health and Disability Prevention Program (CHDP) is dental disease. CHDP data for FY 1998-99 show that of 19,187 children who received dental assessments, 2,683 (14%) had dental problems.

Since 1992, San Mateo County has contracted with the California Department of Health Services to provide a dental disease prevention program for 3,000 elementary school children, grades preschool through six. The reimbursement rate is approximately $8.00 per child. The program, called "Brighter Bites", is the only school-based dental health promotion and disease prevention program available in the county. The program operates in areas of the county where drinking water is non-fluoridated or partially fluoridated, and in schools with a high percentage of students enrolled in the free lunch program. Targeted schools are located in the following five school districts: Jefferson, Ravenswood, Redwood City, Cabrillo, and La Honda.

Discussion

Components of the Brighter Bites program include: 1) weekly fluoride mouth rinses for thirty weeks; 2) plaque control via daily tooth brushing; 3) classroom oral health education; and 4) dental sealant screening and application of sealants as indicated. Dental sealants have proven to be extremely effective in preventing tooth decay. Staffing levels do not allow for local tracking of each child, but national statistics show that once applied, sealants reduce the rate of dental decay by eighty percent.

During the fiscal year 1998-99, 2,293 children received a dental screening through the Brighter Bites Program. Of these children, 849 (37%) had Class II or Class III dental problems. Class III is considered the most severe, requiring interventions such as root canals, treatment of advanced periodontal disease and relief of acute pain. Class II is considered less severe, requiring intervention such as fillings. All children needing treatment are referred to County and community clinics or private practices for their dental care.

Program Indicator

FY 1998-99

Actual

FY 1999-00

Actual

FY 2000-01

Actual

FY 2001-02

Estimated

FY 2002-03

Projected

Number of children participating

3,017

3,000

1,101*

3,000

3,000

Number of children receiving dental screening

2,293

110*

0*

1,065

1,065

Number of children receiving dental sealants

0**

40***

0**

478

478

* The Children's Dental Health Coordinator position was vacant for five months during the 2000-01 school year, resulting in these indicators being at lower levels for that time period

** Sealants did not become a requirement until FY 2001-02.

*** Program voluntarily applied sealants to 40 children.

The workplan for the state Brighter Bites program now includes application of sealants, but funding for this activity is not provided by the state. This year's funding for the application of sealants has been provided through a grant from the Health Plan of San Mateo. Future funding for sealants is uncertain. However, the program will be working to continue volunteer work from private dentists and Foothill Community College. Staff will pursue funding of sealants through grants and donations.

Vision Alignment

The contract with the State Department of Health Services keeps the commitment of ensuring basic health and safety for all and goal number 5: Residents have access to health care and preventive care. It also keeps the commitment that leaders work together across boundaries to preserve and enhance our quality of life and goal number 23: Leaders throughout the County provide the impetus for broader regional solutions in land use, housing, childcare, education, health and transportation. The contract contributes to these commitments and goals since the program works collaboratively with various school districts to promote good dental health and reduction in dental disease among at-risk children.

Fiscal Impact

The contract is effective July 1, 2001 through June 30, 2004. This contract was received from the state for processing in late December 2001. The contract provides funds in the amount of $24,429 for each of the 3 years of funding: FY 2001-02, FY 2002-03, and FY 2003-04. The cost of the program for FY 2001-02 is approximately $32,900. The net county cost of the program is $8,471. The revenue and expenses for this program are included in the approved FY 2001-02 budget. Future budgets will include appropriate revenue and expenses.