California Initiative: Phase II

Goals and Objectives

The Phase II California Pipeline programs runs from July 2007 to June 2010.  The California Endowment is funding all five California dental schools.  The goal of the Phase II Pipeline program remains the same as the Phase I project: to reduce disparities in access to dental care.

The objectives include:

Community-Based Education
The grant provides financial incentives for dental schools and FQHCs to form partnerships.  This is an effort to increase the time that senior dental students and residents spend in FQHCs providing care to underserved patients and to increase FQHC productivity.  FQHCs negotiate with dental schools to share the surplus revenues generated from student and resident services, after their marginal costs are reimbursed.  The financial incentives are reduced over three years, because the partnerships are expected to continue without external subsidies.

Each school is expected to form partnerships with at least three FQHCs (or other community health centers).  Thus, a total of 15 FQHCs will participate in the partnership program.  Each school will also have relationships with many other community health clinics that do not involve any financial incentives from The California Endowment.

In addition to providing FQHCs more providers, the Phase II program attempts to improve the efficiency and effectiveness of FQHC dental programs so that more patients are treated and receive high quality care.  National and California data suggest that the productivity of many FQHCs can be improved through better clinical management.

To increase efficiency, dental school and the California Pipeline Program Office offer FQHCs a range of services.  Some of these services are partly subsidized by the incentive funds.

Management consultations
Quality assurance program consultations
Management training for dentists and staff
Clinical continuing education for dentists and allied dental health personnel
Telemedicine specialty consultations
Specialty services provided by specialty faculty and residents

Cultural Competency
To further advance the capacity of dental schools to care for diverse populations, the Phase II Pipeline program focuses on several initiatives:

Improve the capacity of dental school and FQHC partner clinics to treat diverse patient populations by increasing the availability and quality of translation services and clinic signage and patient information in multiple languages.

Have schools collaborate to develop methods to assess the didactic knowledge, attitudes, and skills of students and residents to care for diverse patients groups.

Examine the feasibility of having the five dental schools participate in an external cultural competency audit of their entire organizations.

URM Recruitment
The current recruitment programs continues and the goal is to increase URM/LI enrollment to 20 percent of the 2011 entering class.  Several new initiatives are planned to achieve this goal:

Expand the post-baccalaureate (PB) programs run in northern and southern California to at least five students per school.  Thus, a minimum of 25 PB students will complete the program annually and 80 percent are expected to enroll in dental school.

Develop a summer enrichment program in northern California that involves the University of California at San Francisco, the University of Pacific, and San Francisco State University.

Work with the California chapters of the National Dental Association, Society of American Indian Dentists, and Hispanic Dental Association to recruit and mentor more underrepresented minority dental students.

Health Policy
The goal is to change health policies at the state and national levels to sustain the Pipeline program after Endowment support ends.  The objectives are:

Maintain contact with major organizations in California interested in health policy and collaborate with them when there are opportunities to advance Pipeline objectives.

Help coordinate the response of the five schools to policy issues that develop over the next three years.  Select one or two policy issues to promote with key stakeholders.  Identify special research projects to provide data that may influence legislation.

Other Collaborations
The California Pipeline program has three year subcontracts with the California Dental Association (CDA) and the California Primary Care Association (CPCA).  The CDA hosts an annual dental health policy summit of key stakeholder organizations.  The CPCA disseminates the best practices from the California Pipeline program to other community health dental clinics throughout the state.  This involves meetings, newsletters, and other forms of communications.

Management

The Program Office for the Phase II California Pipeline program is based at the University of Pacific, Arthur Dugoni Jr. School of Dentistry which is located in San Francisco.  The Program Office is responsible for administering the Pipeline grant.  This includes distributing funds from The California Endowment to the schools and partner FQHCs, providing technical support to participating schools and clinics, monitoring the performance of grant recipients, reporting to The Endowment, and communicating with external stakeholder organizations.

The Pipeline program Co-Directors are Paul Glassman (University of Pacific), Sandra Bolivar (University of Southern California), and Dr. Howard Bailit (University of Connecticut).  Ignatius Bau and George Zamora are responsible for managing the Pipeline program for The California Endowment.  To coordinate the Phase II Pipeline programs sponsored by The California Endowment and the RWJF, Dr. Allan Formicola and Kim D'Abreu, the Co-Director and Deputy Director of the RWJF project, respectively, work closely with the California Program Office.

The California Pipeline program operates with three core committees:

Community-Based Dental Education (William Bird – Chair)
Cultural Competency (Linda Centore – Chair)
Recruitment (Kathy Candito – Chair)

In addition, a Health Policy Group, headed by James Crall, reports to the Community-Based Education Committee.  Where appropriate, committee membership includes representatives from other stakeholder groups: FQHCs, CDA, CPCA, and the dental public health community. The Committees meet twice each year and have monthly conference calls.

The California Pipeline program has an annual two day meeting in May.  In addition, the five California Project Directors participate in the annual meeting of the RWJF Pipeline program.

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