UK NFV CHC Oral Health Service Expansion

The UK North Fork Valley Community Health Center (UKNFVCHC) is a co-applicant with the University of Kentucky, operating an FQHC from two facilities in Perry and Knott Counties and offering primary, preventive, dental, mental health, and pharmacy services. The total population of the UK NFVCHC service area is 38,025, of which 19,387 (or 51%) are below 200 percent of poverty. The eleven census tracts cover three counties and encompass three Medically Underserved Areas/Populations (MUA/P) and three Federal Health Professional Shortage Areas (HPSA) in the heart of Appalachia. Two of those counties also comprise the federally designated southeastern Kentucky Promise Zone. A combination of geographical, cultural, and financial barriers have prohibited local residents from obtaining necessary health care in this persistently impoverished, mining-dependent community, and the impact has been exacerbated in recent years by the demise of the coal industry in southeastern KY. The oral health of this Appalachian community is extremely poor, and may actually be the worst in the nation (see local data below). UKNFVCHC has operated a highly successful mobile dental outreach program (MDOP) since 2005. Data has been collected and analyzed since the baseline year and compared to state and national data. In 2001, a KY oral health survey showed untreated tooth decay rates of 28% overall, and 33% in eastern KY. In 2005-08, the National Health and Nutrition Survey reported rates of 21% overall, 25% for children living in poverty, and 69% in the remote Alaskan Native populations. In 2006/07, our MDOP found rates ranging from 42-71%, averaging 69% overall, equivalent to the worst in the nation. The MDOP has spent the past 10 years providing preventive dental care, education, and extensive case management to nearly 10,000 children and recently celebrated their 10th anniversary by announcing that untreated tooth decay rates have decreased from 69% down to 51% (a drop of 18%). Furthermore, urgent dental rates (pain, infection, rampant tooth decay) have dropped from 22% down to only 8%. This program is now a state and national model, listed as one of five model programs by the Kentucky Institute of Medicine and selected as one of 25 nationally recognized Workforce Innovations in the Provision of Preventive Oral Health Services by the Robert Wood Johnson Foundation. Initially, only preschool through 3rd grade were served, now it extends through 8th grade; participation rates have increased over the years to around 40%, much more than the current program staff can handle, and there are requests now to serve the high schools.