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					                          IFLOSS Coalition Meeting Minutes
                                  July 11, 2006
                                  Bloomington
                                  July 13, 2006
                                   Carbondale
                                  July 19, 2006
                                     Chicago


Welcome                                                      Lisa Bilbrey

Meeting Participants – Bloomington
Lisa Bilbrey, Anne Clancy (IDPH, DOH Chicago office), Julie Janssen (IDPH, DOH
Central Office), Judy Redick, Ann Roppel (IDPH, DOH Champaign office), Andrea
Schroll (IDPH, DOH Central Office), Rose Mutzbaur (IDPH, DOH Central Office).

Susan Albee - McLean County Health Department

Carrie Neff - Knox County Health Department
They will have a dentist (starts August 1) soon who will be full time. The clinic will
open part time September 1.

Dr. Cliff Brown and Deborah Hess-Brown - Dental Sealants & More, Peoria

Leslie Frederick - University of Illinois, Division of Specialized Care for Children

Stacey DeJaynes - PCCEO Head Start

A speaker from United Way of McLean County spoke on what United Way was looking
to do in the area of oral health. In the past they have funded oral health agencies. Their
new thrust is to look at root problems and move upstream to determine why problems get
to the crisis point. Dental problems in the young were brought to their attention so they
have convened a task force. Their goal is to provide education in some form. They want
to give information to parents at birth. They are conveners, not originators.
Andrea Schroll noted that she would like for them to use the tool that the Illinois
Department of Pubic Health, Division of Oral Health, developed that is being used in
WIC clinics.
Leslie Frederick asked if the materials could be used by other organizations. United Way
would hope that they can find something that is already available. The pediatricians and
family practice physicians have material that Head Start uses.

Ruth Liesen - Adams County Health Department
They are getting three new dental chairs, a full time dentist, and a dental hygienist who
will become full time.
Lisa Bilbrey                         IFLOSS Coalition Report
Membership

The coalition has 91 dues paying members with voting privileges, 5 of which are lifetime
members. Members receive renewal information based on the enrollment date.

IFLOSS List Serv

The address to sign up is: http://mailman.outfitters.com/mailman/listinfo/iflosscoalition
You may also sign up by emailing Lisa at info@ifloss.org and requesting it. Please
remember list serve etiquette. If you wish to RSVP for an event or meeting, contact the
person directly instead of “replying” to the email. Please save replies for information that
may benefit the entire list serve. The goal is to not clog up everyone’s email.

IFLOSS Board of Directors

The Board has met three times since the March regional meetings. The accomplishments
are: establishing the check signing/expenditures policy and creating a financial reserve
fund and a money market account.

Several other items have been discussed and will be reevaluated under Old Business at
the next scheduled Board meeting in September. These items include: Grant Support
Policy and Election/Succession procedures.

Minutes from all Board meetings are kept on file at the IFLOSS office.

Spring Oral Health Conference

IFLOSS and the Division of Oral Health are gearing up again for their biannual oral
health conference. We are looking for suggestions for Month/Location/Topics.

Lisa Bilbrey discussed the dues structure briefly. The dues were established in 1998 and
there has been no change since then. The Board asked her to research similar programs
and their structure and dues. In April the Board voted to increase membership dues. The
change would be effective September 1. Members could vote to approve or disapprove
the proposed structure.

Judy Redick     Policy Development and Legislative Committee Report

The Policy Development and Legislative Committee met by conference call on Tuesday,
April 25 and Tuesday, June 6, 2006. .

Dr. Lampiris reported that the steering committee for Oral Health Plan II (update/revision
of the Oral Health Plan of 2002) met on March 10. The Illinois Rural Health Association
will partner with the Division of Oral Health, fiscally and with staff assistance, for the
plan. Some of those committed to participating in the development of the plan include
Representative Renee Kosel; Senator David Miller; Lt. Governor Patrick Quinn; Anne
Marie Murphy, Illinois Department of Health and Family Services; Robyn Gaebel,
Illinois Maternal and Child Health Coalition; Dean Susan Scrimshaw, School of Public
Health, University of Illinois at Chicago; doctors from the dental schools; Division of
Services for Special Children, University of Illinois; and Jerry Stermer, Campaign for
Better Health Care. Town hall meetings have been set and a summit will be held in the
fall (October 11 or 24).

On the legislative front, SB 2395 was amended in the House. The amendment stated the
Department of Finance and Professional Regulation could conduct a census but only
dentists would be required to fill it out. There is $75,000 in DFPR’s budget to support
the study of the oral health workforce.

A group of national foundations met in Massachusetts to find out how foundations can
make an impact on policy in oral health. The purpose would be to advance individual
knowledge about what is possible in terms of improving oral health by affecting policy
change. Catherine Dunham of the Robert Wood Johnson Foundation’s funded Access
Project in Boston would convene meetings two or three times a year so that state oral
health programs could learn from each others’ work. Ms. Dunham would collect
knowledge and insights about what oral health promotion policies have been or are in
various states. They would like to visit Illinois and Carolina. The foundations include
the United Methodist Ministries, Washington Health Services, California Endowment,
Colorado Endowment, and Mid-Iowa Foundation. They will meet at the Abraham
Lincoln Presidential Library on June 12 to discuss how Illinois has succeeded in the
policy development area and how they could assist us in garnering foundation support to
further policy development. Dr. Lampiris, Ray Cooke, Susan Kerr (Illinois Children’s
Healthcare Foundation), and Lt. Governor Patrick Quinn will make presentations.

The first IFLOSS Board Meeting was held on April 7. It went very well. They have a lot
of policies to establish. The next meeting is scheduled for September.

A couple of dates have been set at the state fair for dental exams for children (August 14
for half a day; all day on the 18th). Last year there were about 60 children who were
checked. IFLOSS needs to have a display on those days in the booth.

Next conference call is scheduled for July 25.

Greg Johnson - Illinois State Dental Society
He distributed copies of a survey that they just completed of all other states
reimbursement rates for Medicaid services to see where Illinois ranks. On the second
page of the report the average of all 50 states is noted and where Illinois ranks nationally.
Illinois does very well rate wise with Oral periodic evaluation (D0120), Prophylactics for
children (D1120, and Sealants (D1351); in all other areas Illinois is at the bottom.

There is concern about the school programs because of this disparity. There is little
thought given to follow-up to get care for problems identified in the school exams. The
Department of Health and Family Services (DHFS) is looking at preauthorization of
school programs. If an agency is going to a school, they need to tell DHFS; if DHFS
wants to come and observe they can.

Another issue is patient abandonment. Every school program is literally doing that.
Instead of giving out the Doral number for referral, they may have to organize something
in the community for these children. There are more and more school programs but less
work being done.

The dental manual will be updated in the next six months.

There was $126 million spent last year on Medicaid oral health programs and DHFS was
about 11 weeks behind in payments. They have budgeted $125 million for this year.
There will be four payments through the fall; maybe eight weeks in processing payments
by January 1; and a 75 day wait by the end of the fiscal year.

The Doral contract is up and DHFS is required to put out an RFP (Request for Proposal).
The RFP will go out in August or September, and the contract starts March or April 1.

Doral was required to do a survey of Medicaid parents/guardians. The results of the
survey of the 100 who did not get dental services were presented to the Coalition.
Results were consistent in 2004/2005:
      More than half of the parents were aware of dental benefits
      29% said they could not find a dentist but did not contact Doral to see if they
         could locate a dentist for them
      32% did not take their child to the dentist due to transportation, work, child
         afraid, child in pain, or parent could not afford costs.

The State Dental Society Foundation offered money for grants this year ($15,000). They
had nine grant requests and the winners will be announced in September.

There are 43,000 children enrolled in All Kids. In reality, there about 4,000 new
enrollees; others were transfers from KidCare. Depending on the level of program they
are in, there are co-pays. If in Level 2-8, there is a schedule of $25 co-pay if you do
something other than prevention; $15 for certain levels; $10 for another level.
Money ($75,000) will be transferred from the Dental Disciplinary Fund at the
Department of Financial and Professional Regulation to the Department of Public Health,
Division of Oral Health, to pay for the survey of dentists and dental hygienists. The
survey is not mandatory or part of the license renewal process.

Dionne Haney – Illinois State Dental Society



Julie Janssen - Illinois Department of Public Health, Division of Oral Health
Dr. Lampiris left the Department of Public Health on June 30 and will be working for the
American Dental Association, Access To Care Council. His official starting date is
August 1. To maintain the partnerships that are needed in the interim, Julie Janssen has
been named Acting Division Chief.

Early Childhood Carries (ECC) Prevention Program – funded by HRSA. They are in the
third year of the grant and will apply for a continuation grant. Andrea Schroll created a
manual that WIC and Head Start programs are using. They also have a flip chart with the
program manual. Both programs are working with families to teach them about the
importance of oral health. One hundred percent (100%) of the WIC agencies have an
oral health program. An evaluation survey is provided with the program.

The Division of Oral Health hopes that the training that the American Academy of
Pediatrics is doing with pediatricians and family practice physicians will be beneficial
and the physicians can bill Medicaid and be reimbursed. DOH is working with DHFS to
help physicians get reimbursed for varnish applications. They would also like to have the
WIC and Heat Start staff be trained to do fluoride varnish and get reimbursed for the
placement and anticipatory guidance.

Head Start programs are participating in a randomly stratified survey. Data that they are
collecting includes untreated decay, carries experience, and urgent treatment needs.
Approximately 60 Head Start agencies were chosen to do the survey. DOH is working
closely with Region V federal office on the survey and data collected.

June 30 is the end of the period for schools to report data to the Illinois State Board of
Education on the dental exams for kindergarten, second, and sixth graders. Division of
Oral Health staff has already met with ISBE to discuss the process of retrieving the data
and they feel that by mid July they will have the data for them. They will take the data
off the form – exams done, those not done, children who had waivers. Next year they
should gather additional information for IDPH.

DuPage County has a fluoride varnish program with Head Start agencies. DHFS is doing
a three-year study and it will be several years before they get the results.

Oral health grants have been sent out and are due back July 14. DOH had same amount
of money as last year. They hope more children will get services through All Kids.
Grants are being changed from the federal fiscal year to the state year so there will only
be a nine-month program this year.

SEALS program, created by CDC, is being provided to local health departments. It will
help them calculate averted disease and cost effectiveness. Illinois is involved in revision
of program due to our great sealant program.

ASTHO has been working with a consensus work group for two years on the
effectiveness of school-based programs. They hope to highlight the study at the spring
conference.
Fluoridation – have had some systems that have fluoride program for over 20 years.
Dental curriculum pilot program – Andrea reviewed programs from all over the U.S.
Cavity Busters was chosen. Staff is now working on corrections or additions to make
sure schools will use it. The curriculum is available in English and Spanish.

RWJ grant with HFS/ISDS/ IDPH/Doral Dental – working to make sure programs are
impeccable.

IPHCA organization and FQHCs are getting on board with the sealant program, another
piece of the dental home. One session in their fall conference is on sealants; CEUs
offered. Will hope it leads to a track on oral health.

Expect new application from HRSA to look for fresh issues - building skills of
workforce, building capacity at the local level, and specialists in rural Illinois.
Grant is for $100,000 per year for three years.

CDC Infrastructure Development Grant – grant in its second to last year. DOH received
the same amount as last year. Public Health Block Grant dollars were used in the past for
oral cancer grants.

Foundations met in Springfield for special dental group meeting. Wanted to learn how
the Division and IFLOSS do as much as they do without significant funding. Susan Kerr,
Illinois Children’s Health Care Foundation, asked if ICHCF could fund IFLOSS. Dr.
Lampiris and Ray Cooke presented. Lisa Bilbrey will have talk with Susan the end of the
week about bringing foundation money in to support IFLOSS efforts in the area of a
literature library with bilingual documents.

Town Hall meetings – good questions provided and they stimulated a lot of discussion.
Spent a lot of time talking about special populations, fluoridation needs to be noted.
After the town hall meetings the steering committee will meet again in August. The
Summit meeting will be on November 14 in Chicago.* Reproduce format that they had
the first time. After that the document has to be published.

A chart showing the location of all the public health dental clinics and schools in Illinois
was provided by IDPH staff.

*Due to fall veto session, the Summit meeting will be held on Monday, November 13
at the Executive Mansion, Springfield, from 2:30 p.m. to 4:30 p.m. A reception will
follow at the Executive Mansion.



Dr. Brown
How should a health department communicate with school districts about oral health
issues? Where do issues go? Who receives? If you communicate with superintendents it
stops there
Deb O’Connell – Heartland Head Start
Stephanie Pottorff – Heartland Head Start

Maureen Sollars – McLean County Health Department, All Kids



                             July 13, 2006 – Carbondale

Meeting Participants – Lisa Bilbrey, IFLOSS staff, Mary Christen (IDPH, DOH
Edwardsville Region), Julie Janssen (IDPH, DOH Central Office), and Judy Redick,
IFLOSS Consultant

Lisa Bilbrey conducted the meeting due to the absence of Ray Cooke, President.

Fred Bernstein - Community Health & Emergency Services (CHESI)
Thanks to those who provided support for ILCHCF grant to get oral surgeon in Cairo.
Now they are looking for dental assistants.

Bobbie Worthington - Southern Seven Head Start, Health Services Coordinator

Sandy Maurizio - SIUC Dental Hygiene Program, Community Dental Center
The community center is open three days a week during the summer with two dentists
and two students. They go to the migrant center starting Monday.

Teri McSherry - SIUC Dental Hygiene Program, Community Dental Center
They are going to Head Start programs.

Sherri Lukes - SIUC Dental Hygiene Program
They have a grant from ILCHCF for low income children. The program is conducted in
a church in the summer, doing sealants.

Two dental hygiene students were present also.

Charla Lautar - SIUC Dental Hygiene Program
March is the ADEA meeting.

IRHA is sponsoring a grant writing workshop.

SIUC surveys all Medicaid clients. Main reason for them is that they cannot find a
dentist who takes Medicaid.

IFLOSS is an advocacy program. They need to have a representative on the legislative
and policy committees of IPHA and IRHA to get their message out there.

Sherri Lukes
How many private practice dentists are using varnish? It does not seem like there are a
lot yet. Used in Canada in the 70s and in Europe.

How many are recommending seeing a dentist at one year of age? Protocols are available
for medical needs, should make them for oral health.


                                  July 19, 2006 Chicago


Meeting Participants
Lisa Bilbrey, Anne Clancy (IDPH, DOH Chicago Region), Julie Janssen (IDPH, DOH
Central Office), Ann Roppel (IDPH, DOH Champaign Region), Judy Redick

Dr. Linda Kaste - University of Illinois Chicago, College of Dentistry, IFLOSS
Board Member
Dr. Kaste conducted the meeting in Ray Cook’s absence. There are two activities of note
in the near future – National Oral Health Conference in May 07. It is particularly
important to make plans now if you want to go to the meeting. The deadline for break
out sessions is August 18. From April 30 – May 2, at the Marriott Denver Technical
Center, ASTDDO and AASTDD will have their conference.
The American Head and Neck Society is having a meeting in Chicago with a satellite
meeting the day before. Topic: Early detection of oral cancer.
Dr. Susan Scrimshaw, Dean of the University of Illinois School of Public Health, has left
to be a dean at a college in Massachusetts. A search is being conducted for her
replacement.

Susan Kerr - President, Illinois Children’s Health Care Foundation
They are planning a one-day forum on mobile health on Monday, October 30, in
Springfield. It is scheduled the day before IDPH’s AIDS program

Jina Bryant - Community Health Partnership of Illinois, Director of Operations
The agency’s current project is training peer health educators to work with children and
parents on oral health issues.

Sheila Cochran - Illinois Maternal and Child Health Coalition



Dr. Suzanne Torres - Lawndale Christian Health Center
They have 2 FTE dentists and saw 3600 patients this past year. They are working with
Bright Smiles and trying to see school children at the clinic that are not being seen by the
Chicago Department of Public Health.

Dr. Jerry Cieben - Salvation Army Harbor Light Dental Clinic
Dr. Marcy Borofsky - Smile Illinois

Seema Kamath - Illinois Department of Public Health, Intern

Suzanna Roberts Davison - Kane County Health Department, Consultant

Mila Tsagalis - DuPage County Health Department, Oral Health Program –
She has a grant from the Illinois Children’s Health Care Foundation for a mobile oral
health unit (available in September). She is also helping to put a town hall meeting
together tomorrow in DuPage County.

Tom Kropidlowski, DDS - Chicago Department of Public Health, School Health
They will be bringing on at least two dentists, maybe three, within the next month. They
will be assigned to some clinics - the program is in transition. Dr. Carlos Parai is the new
dental director for school-based clinics. They have requested 6 dental assistant positions.

Mary Pat Burgess - Chicago Department of Public Health, School-Based Program
They had 5 contracting providers by themselves this year. Most of the doctors didn’t
start until end of February or March due to contract negotiations. They were in 365
schools, saw 24,000 students in K, 2, 6, and placed 74,000 sealants plus prophys and
fluoride. They are completing negotiations now with Chicago Public Schools and will
put out a RFP for dental services. This year they will see PreK, K, 2,3, 6th and 8th. In the
next two years all grades K-8 will be served, then over ½ million students.
Chicago Department of Health has invested in equipment to scan dental charts to be used
in their exams in 2007-2008. A year from now they will probably be able to scan billing
sheet rather than doing by hand.

Dr. Cieben asked how many students seen in the school-based program needed urgent
care. Ms. Burgess stated that very few that were seen needed urgent care, and they do
have 2 providers to refer the students to. They moved their offices to 4314 South Cottage
Grove, Chicago 60653. Phone number is 312-747-8304; fax is 312-747-8305.

Charles Czerepak, DMD - Pediatric Dentist

Faye Manaster - The Arc of Illinois Family to Family Center

Elizabeth Lippitt - Oak Park Infant Welfare Clinic
They have expanded into a new store next to their building and will start renovation next
week. They will expand from three chairs to five and will have dental students working
there four days a week.

Kim Frankovich - Aunt Martha’s Health Network
They have three dental clinics now and will have nine by the end of next year.

Kris Burzlaff – CHP Dental Clinic, Aurora
Dr. Jerry Dismer - Lake County Health Department

Joe Weimholt – Il Maternal and Child Health Coalition
Not a lot of new information on All Kids. Expansion has provided 5,000 new enrollees.
New population could apply in April. They expect the expansion number to increase.
They are working with the Governor’s office and DHFS on back to school campaign.
They are trying to bring in new organizations, churches, and communities to do outreach
in the communities.
Citizenship verification project – their biggest concern – everyone receiving and applying
for Public Aid has to prove citizenship (passport, driver’s license). In June guidelines
came out from the federal government. State has put off this requirement until they can
make it less burdensome. They are doing an electronic match with the Division of Vital
Records. No one will be denied at this time. Applicant cannot send in a copy, have to
show proof. Only providers being allowed to enroll as pcps are FQHCs and rural health
centers. Will have to reselect a pcp in January or March. Provider will automatically be
enrolled based on previous health care behavior.
Mr. Weimholt did provide a copy of the questions raised at the March 29th Chicago
meeting.

   1. How long will it take for dentists (and all other providers) to be approved to
      become an All Kids provider? Currently it has taken a clinic several months to
      register clinic providers as a Medicaid provider and they still aren’t able to bill for
      Medicaid today. Who is a direct contact in HFS to help with this issue?

   2. For families above 200% FPL who have private insurance through their employer,
      but may not have dental coverage for their children, will All Kids provide a buy-
      in option to get this coverage? NO

   3. Will there be special carve outs to create a special fee structure for areas that have
   vulnerable populations with no present access to dental care? Other state Medicaid
   programs have done this within their state plans to ensure better access to care. Ex:
   For those patients in rural, central and southern Illinois, that may not have access
   presently to a dentist, whether or not they are enrolled in Medicaid, getting them into
   All Kids and having them pay monthly premiums will not necessarily get them an
   appointment with a doctor or dentist.

   4. What will be the rule for families who don’t pay their premiums? Providers are
   concerned that families will only pay monthly premium for those months when they
   plan on using medical services. One provider mentioned that her clinic has had
   challenges with several families who have had their medical card suspended for non-
   payment of premiums, but the family has said that they just mailed the check. In this
   case, the clinic wants to serve the family, but they also want to ensure payment from
   HFS – is there another way for them to verify this information? What is being done
   by HFS to ensure that families don’t just pay premiums when they need services?
   Two months without payment, the client is cancelled.
   5. If a child visits a provider that is not listed as their PCP, will that provider be paid
   by HFS?      YES, for up to one year.

   6. Currently, only MCH providers can receive the enhanced reimbursement rates.
      Can an entire clinic sign up to be an MCH provider in order to receive these rates?
      If so, could you please provide the instructions/paperwork on how to do this? Sue
      Hickerson.

   7. Are there any MCOs that don’t provide dental coverage? We’ve served children
      that are on Medicaid Managed Care and we cannot bill them because they don’t
      have dental included in their package.

   8. Will dentists receive any of the case management fee that will be paid to other
      doctors? (Tentative) no


Next Chicago meeting is scheduled for November 29.

				
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