Healthy Teeth with Care

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“I love to give to my community,” says Perla Quiñones of Native American Health Center, Oakland.  I feel like I know this community to know that if we give to them, they will give back to us.” The Community Dental Care Coordinator (CDCC) was born and raised in Oakland and was a La Clínica patient as a child. In her position she sees the daily exchange of caring between patients and staff.

Quiñones has taken on a pivotal role in expanding access to care for more members of the community through Healthy Teeth, Healthy Communities (HTHC). The program aims to improve the dental health of Alameda County children age 0-20 enrolled in Medi-Cal.  HTHC answers a critical challenge in the community and is made possible through the Medi-Cal 2020 1115 Waiver Local Dental Pilot Program. Of those eligible for Denti-Cal services in Alameda County, only 1 in 7 children were getting recommended annual preventative dental care. CDCCs are part of the program’s strategy to increase care coordination through a workforce who are linguistically and culturally responsive to their community.

“To be a care coordinator means to have the opportunity to talk to patients and to get them into the clinic, to give them the dental education that they need and to be available to them whenever they need us. And, I do this not only for dental care. We have other resources they can access like behavioral health services, medical, eligibility and others.”

One of the keys to getting more kids into care, according to Quiñones, has been data. “We run reports to identify patients that we haven’t seen in more than a year.” She uses the reports to conduct in-reach (across departments) and outreach to the community. “We have a goal for HTHC of 179 patients with continued care which means that after their six months they come in again.  Right now we are doing so well that we are going to exceed that.”

Native American Health Center’s success results from carrying out a series of steps to engage the patient and family. “What I usually do is talk to them about the program and set up an appointment, fill out paperwork. Many of our patients are working one or more jobs or caretaking so they don’t always have the time to sit down and talk for 20-30 minutes – we can do it over the phone.” Before the patient arrives to the appointment, she explains the procedure, and on the day of she meets them in the waiting room.  “If they are comfortable and want me to be there with them, I’ll be there. We encourage them to come in every 6 months, and I’ll call and let them know that it’s time for them or their kids (if they are younger) to come in for their 6-month appointment.”

Quiñones, similar to other community health workers, exemplifies a CDCC’s unique trust, connection, and shared experiences with patients.  As a former health center patient, she understands the experience of accessing care the community context of their care. Linguistic and cultural competency plays an important role in the care coordination role. “In our clinic we have a large Latino population, and I know that just speaking their language and having that good connection allows them to open up. Once they open up, they’ll ask for help. They will also be open to listening to tips like how it’s important to brush twice a day.”

A positive connection with a CDCC opens the door for more conversation and care, allowing the patient access to the full array of health center services. “I have patients that started coming in here for dental and I schedule their medical appointments as well as help their parents with appointments. Our eligibility specialist who helps with Medi-Cal, HealthPAC, CalFresh, and other insurance also helps. Once she gets families in for a new application, she’ll know that they haven’t seen a dentist and she calls me and I’ll come over to speak with them.”

Happy patients refer other patients. “I notice that if you treat your patients well and they feel comfortable with you they will bring other patients in. I had a patient who was so happy that she referred her friend whose kids needed dental services and they had been looking for years.”

After almost four years at the health center, Quiñones feels as committed as ever to the mission and patients. “We have low-income patients and they do get frustrated at times. They come in with pain, but if you talk with your heart and honestly, we can relate to each other. I have patients who come in and ask for me just to see how I’m doing. They care, and that is what makes me love working here.”

Read more in this article about the pivotal role of Community Health Workers like CDCCs in oral health.