Lack of insurance and transportation are two major barriers preventing underserved children and adolescents from receiving deserved medical and dental care. Half a million children in our state lack health insurance. Our county's percentage of children under 18 living in poverty is higher than the nation's. We rank fifth in our state in HIV/AIDS cases. Oral Health America estimates that for every child lacking medical insurance, 2.6 children lack dental coverage. Through a new mobile health care initiative, pediatricians, nurses, dentists, and residents drove over these impasses with a state-of-the-art vehicle built specifically for delivering free pediatric medical and dental care in the community schools.
Discussion This program was launched in February 2006 in partnership with our school district, the ninth largest nationwide. Additionally, our program's community partners include the county dental association, a dental hygienist program, a domestic violence center, after-school teen centers, a homeless shelter, and a home for abused and neglected children. After 8 months of operation, 1,138 students from 5 high schools, 10 middle schools, 15 elementary schools, and an exceptional school; in addition, children from a homeless shelter, domestic violence center, and child abuse/neglect center. Preliminary wireless EMR data showed that 279 patients were seen for a well-child care/sports physicals, with 638 acute visits. Sixty-nine percent were uninsured and 23% had Managed Care Medicaid, with the remaining 8% private insurance or straight Medicaid. This program is fully incorporated into our residency program. Teaching residents the unique sensitivities and challenges of community/school collaboration and providing medical/dental care to underserved children is critical to bridge cultural and access barriers. In addition, residents are taught Oral Health Risk Assessment (OHRA), an AAP initiative, in collaboration with the mobile van dental experience. This initiative connects children's medical/dental and educational “homes” and supports the school district's wellness policy.
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