Category: Blogs

Oral health programs and policy lead to better health outcomes for our state’s children. 

Heather again! In my first blog, I told you about the history and successes of ABCD. In part 2, I’ll talk about how the continued support of legislators allows us to build on our successes.

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Statewide investments in healthier childhoods. 

Last year was an exciting time for the ABCD program. With funding from the 2021 legislative session, we deepened outreach to families of color for children under age 2 and expanded ABCD to serve children with developmental disabilities through age 12. As of January 2023, 173 dental providers are now certified to provide care to this newly covered group of children with special health needs.  

The ABCD program would not be possible without our statewide network of certified providers and champions. Nearly 4,000 dental professionals use their time and talents to ensure children from lower-income households receive the same compassionate, attentive care as any other child. In the 2022 legislative session, the state recognized their invaluable work through a $21.1 million investment in fee-for-service pediatric Medicaid rates. These new Medicaid rates in turn helped support the highest ABCD reimbursement rates ever. 

Investments like these show the state’s dedication and commitment to a healthier, more equitable state. The 2023 session is another opportunity to strengthen this commitment through several bills and budget ask with the goal of improving oral health for children and their families. 

Increased access to care for Apple Health (Medicaid) enrollees.

DentistLink is a no-cost dental referral service designed for people with Apple Health (Medicaid) or no dental coverage. This service helps individuals quickly and easily find care in their community. It’s also an invaluable tool for our ABCD program when connecting families to a local provider. 

2022 was DentistLink’s first full year as a formal public/private partnership between Arcora and the Washington State Health Care Authority. Funding in the 2021-2023 state budget established this agreement. We’ve seen great successes in this partnership. Our free Find-a-Dentist tool was accessed more than 70,000 times, helping to connect people to the right dentist for their needs. Our outreach team connected with the community through 50 partner outreach events across the state. Through continued state investment in this partnership, DentistLink can continue to scale up and connect more Apple Health (Medicaid) enrollees to dental care. 

“DentistLink is a lifesaver. Without you I would probably never have seen a dentist. I’m so very grateful. You seriously saved my life.” 

Randall
DentistLink user
Colbert, WA 

Prevent tooth decay through community water fluoridation. 

Cavities are the most common chronic condition of childhood. While some may view cavities as an expected part of life, we know that tooth decay is largely preventable. Yes, a cavity-free childhood is possible! 

Community water fluoridation is the most effective and equitable way to ensure everyone benefits from this proven form of cavity prevention. In 2022, the state provided $532,000 for the Office of Drinking Water in the State Department of Health to establish a program to support local water systems and provide outreach on community water fluoridation. HB 1251/SB 5215 will further improve awareness for residents who already have access to fluoridated water. To use another classic saying, “Knowledge is power.” 

In addition to these oral health initiatives, I encourage our state policymakers to invest in other programs that support the health and wellbeing of children in underserved communities—including support for community health centers and school-based health centers, universal free school lunch, and funding a Medicaid-equivalent program for our immigrant community members.  

Heather Gallagher is the Managing Director for the statewide Access to Baby and Child Dentistry (ABCD) program. In addition to ABCD, Heather has managed multiple programs with a focus on early supports for children and families.

Heather Gallagher, ABCD managing director, shares the ABCD program’s secret to making Washington state a leader in young children accessing dental care.

I’m excited to highlight the work of Washington state’s Access to Baby and Child Dentistry program. Look out for my second blog coming out tomorrow, in which I share how statewide investments can further fuel Arcora’s work in bending the arc of oral health toward equity. 

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February is Children’s Dental Health Month. As the statewide Access to Baby and Child Dentistry (ABCD) Managing Director, I may be a bit biased in it also being my favorite month! As the saying goes, “The most precious sight is the smile of a child.” Arcora Foundation is building a future where every child’s smile isn’t just precious—but healthy as well. 

It takes a multi-pronged, integrated approach to support children’s oral and overall health. And we can’t do it alone. Through access to care programs—like ABCD and DentistLink—and prevention measures—like community water fluoridation—our team, in collaboration with partners and policymakers, leads our work with equity to ensure all Washington kiddos can reach their full health potential. 

Supporting children’s oral health through a longstanding system of care.

ABCD launched in Spokane in the mid-1990s as a way to connect Apple Health (Medicaid)-enrolled children from birth to age 6 with specially trained dental providers in their community. In fact, two of those early ABCD patients were my own kids! I was grateful and relieved to have this local service available to me back then; what a full-circle moment to now be leading this program and providing that sense of relief to more parents like me.

When ABCD started, only 20% of Washington state young children accessed dental care. Today, this number has more than doubled (45% in FY2021) for children from lower-income households—making Washington a national leader in the number of young kids receiving essential dental care.

Before my time at Arcora, I had the joy of working directly with families as the Spokane Regional Health District’s ABCD coordinator. The health care system can be overwhelming for anyone, but especially for caregivers looking to give their children the best start in life. Thankfully, the ABCD program and its team of local coordinators help take the stress out of dental care. 

Coordinators are primarily family advocates. Across all 39 counties, ABCD coordinators provide referrals, family education, and additional services necessary to help young children thrive. Does your child need a dental appointment? You got it! Can I also grab you an extra pack of diapers while you’re here? We can help with that, too!

I can’t praise our ABCD managing partners, coordinators, and providers enough. And it’s not just me singing their praises (though trust me, no one wants to hear me sing). The Washington state legislature has proven year after year that oral health equity programs and policies are worth investing in. By deepening and expanding the reach of this system of care, we’re one step closer to Arcora’s vision where all people enjoy good oral and overall health, with no one left behind. 

Caregivers, you’re doing great.

Finally, I want to take a minute to celebrate our state’s caregivers. You are your child’s greatest champion, and we see your dedication to their health and wellbeing. Because of you, they’re on a path to thrive long into adulthood. 

You’re also their first educator for healthy habits. The earlier you start, the easier it will be for these habits to stick as your kids get older. Here are some key habits ABCD recommends to all families: 

• Brush twice a day with fluoride toothpaste. For children under age 2, use a rice grain-sized amount of toothpaste. For children 3 and over, use a pea-sized amount. A good rule of thumb is to help your child brush until they can tie their own shoes. 
• Floss once a day as soon as teeth touch. Flossing can clean 40% of the day’s “gunk” that brushing alone misses. 
• Make water the drink of choice. Plain water is the best drink for a child’s oral and overall health. Ask your doctor and dentist about access to fluoridated water in your community and other ways your child can receive the cavity-fighting benefits of fluoride, such as fluoride varnish. 
• Snack smart. Choose teeth-healthy snacks like fresh fruit, nuts, white milk, and cheese. Limit cavity-causing snacks like juice, candies, fruit snacks, and crackers. 
• First birthday, first dental visit. Children should begin receiving oral health services from a dentist or primary care provider by their first birthday. Apple Health (Medicaid) covers dental services for both children and adults. 

18 organizations receive grants and sponsorships to help address most pressing health needs. 

A request, a need, and a solution. 

In 2021, a client at Seattle’s Tubman Center for Health & Freedom‘s Blaxinate Lounge shared about her untreated oral health concerns. Because the Tubman Health team treated her with respect and empathy, she asked if one of them could accompany her to the dentist. 

This client interaction inspired the team to develop the new Tubman Guides program. It honors this community member and other clients who asked for help to improve their care experiences. Tubman Guides will provide care coordination, emotional support and advocacy, and other wrap-around services to Black community members in Central and South Seattle. Their goal is to promote access to care for people pushed to the margins of the health care system. Navigators—especially those who reflect the communities they serve—play a key role to connect people to care.

Programs like this not only recognize that oral health is essential to overall health, but also the importance of centering solutions to people’s most pressing health issues within the communities where they live. 

A commitment to community-driven solutions. 

At Arcora Foundation, our health equity framework includes the reallocation of power and resources to community-led efforts to prevent oral disease and improve access to care. As part of this work, we’re honored to award $520,000 in grants and sponsorships to Tubman Center for Health & Freedom and 17 other incredible community-based organizations to help more people reach their full health potential. 

These funds will support projects and events that aim to advance good oral health through one or more of the following approaches: 

• Increase access to dental care. 
• Motivate behavior change. 
• Address systemic barriers. 

Expanded partnerships through funding. 

More than 80 organizations applied for this round of funding. We selected recipients, in part, based on how well the project intends to narrow disparity gaps—particularly Black, Indigenous, and communities of color where disparities in oral health are significant. Other factors included the project’s community of focus, the geographic location, the alignment with Arcora’s mission, and available budget. Congratulations to our latest funding recipients: 

• Afghan Health Initiative.
• Alefba Group.
• Alimentando al Pueblo.
• Asia Pacific Cultural Center.
• Chinese Information and Service Center.
• Community Health Worker Coalition for Migrants and Refugees.
• East African Community Services.
• Lifelong.
• Lower Elwha Dental Clinic.
• Pacific Islander Community Association of Washington.
• Public Health Foundation Enterprises, Inc. dba Heluna Health.
• Recovery Café.
• Roni LifeWorks.
• Tubman Center for Health & Freedom. 
• Unity Care NW – Bellingham Health Center.
• UTOPIA Washington.
• YouthCare.
• YWCA Seattle – King – Snohomish. 

We continue to evolve as an organization, including how we reallocate our resources through grants and ongoing sponsorship funding. We thank all the organizations who took time to provide feedback and insights during this latest grant cycle. Sign up for our newsletter to be notified of upcoming funding opportunities and other timely information.  

This article was originally published in The Seattle Times.

By Arcora Foundation | November 30, 2022

Access to regular dental care, a healthy diet and fluoridated water are key factors that determine healthy teeth. When we’re able to obtain the right balance of fluoride in our drinking water, it strengthens our tooth enamel and reduces decay. However, some water supplies don’t contain enough fluoride to help protect teeth against cavities, so a process known as “fluoridation” is used by water systems throughout the U.S. to adjust the fluoride to an optimal level.

Fluoride, also known as “nature’s cavity fighter,” is a mineral that’s found in Washington’s rivers, lakes and Puget Sound. An overwhelming majority of American health experts encourage brushing twice daily with fluoridated toothpaste and drinking water with fluoride to prevent cavities. Fluoridated water also provides a cost-effective way to boost oral health in underserved communities that too often experience barriers to accessing preventive dental care.

Dr. Sue Yoon, Chief Dental Officer, Community Health Center of Snohomish County, has seen firsthand the difference fluoridated water can make. “I did my residency training in Hawaii, where fluoridated water is not available,” Yoon says. “It was incredible, the extent of decay in our patient population. Sadly, Hawaii has one of the highest cavity rates in our country.” Yoon points out that while fluoridated water is just one layer of protection, it does have an impact. “Fortunately, now where I currently practice in Everett, there is community water fluoridation. It’s one of the easiest cavity prevention strategies we can recommend to our patients — just drink your tap water.”

Dr. Russell Maier, M.D. FAAFP, a family physician and associate dean for Graduate Medical Education at Pacific Northwest University in Yakima, cites fluoridated water as one of the top 10 public health measures in the last century. He says it’s “cheap, safe and effective” — and a way to give everyone access, “if we care to help communities with barriers.”

“When we look at health, there are things we can’t control around our genetics,” Maier explains. “Then there are social determinants over which we have some control.” He uses the example of Americans previously experiencing consistent thyroid problems, which was solved by adding iodine to our salt. Now, he says, you hardly ever see issues developing due to a lack of iodine. Along those same lines, after the U.S. began adding supplements to our cereal and milk, health problems caused by a lack of those minerals and vitamins disappeared.

“Adding fluoride to water is a way to reach the entire population, especially those at the greatest risk and who wouldn’t get it otherwise,” Maier says.

When Maier moved to Yakima in the early 1990s, the city’s water system was not fluoridated. As a health care provider, he simply assumed it was, as many people do. He learned he was wrong, he started a local campaign to fluoridate the water, which proved successful.

This effort currently follows a single-water system approach, Maier observes, though he believes a systemic method would prove more effective. “We can keep going one city at a time,” he says, “though statewide efforts show the most success.”

Ileana Ponce-Gonzalez, MD, MPH, president and executive director of Community Health Worker (CHW) Coalition for Migrants and Refugees, is passionate about the work her organization does. The statewide nonprofit, with its headquarters in Edmonds, aims to “meet the needs of underserved communities by creating sustainable opportunities, implementing innovative solutions and cultivating productive partnerships.”

Among their many offerings, the organization’s Oral Health Program works toward prevention in dental health disparities, conducting workshops that share preventive information on oral health.

“Fluoride is not everywhere now,” Ponce-Gonzalez says, explaining why it is more common to notice residents of rural areas covering their mouths when they speak because they are embarrassed by tooth loss or decay. Her teams teach the benefits of fluoride and share that people can talk to their doctor or dentist about fluoride supplements. “Unfortunately, people who live in areas with no fluoride don’t know that,” she says. “It’s important to know because it can prevent infection and tooth loss.”

The impact of cavities extends beyond dental health, for both children and adults, Yoon says. “Early childhood cavities often lead to pain and infection, then treatment needed under sedation. Even as an adult, untreated cavities can cause toothaches that are debilitating. Anyone who has experienced an abscessed tooth knows that it is impossible to function normally until that gets treated.”

The CHW’s Ponce-Gonzalez works with are independent contractors who then serve the needs of farmworkers. “Our model is that we work with trusted members of the community,” Ponce-Gonzalez explains, “and train them in oral health.” She says it’s especially important to pass along the knowledge they do for the sake of the community’s children and those with chronic conditions.

Education creates a domino effect. Ponce-Gonzalez offers the example of two CHWs in Yakima training 25 people from various families; those folks will in turn go home and share the information with their friends and family. “Educating our community is also social justice,” she says.

A dentist who has worked with underserved communities for over a decade, Yoon also supports efforts to spread accurate information on preventive care, emphasizing the role fluoride plays in their work to equip patients with the tools they need for health. “I would love to see more efforts put toward preventive measures. When working with my patients, I’ve yet to meet one who would rather undergo a procedure, instead of preventing the need for it.”

To learn more about community water fluoridation in Washington state, visit WashingtonWaterFluoridation.org.

Arcora Foundation Associate Program Officer Matt Gonzalez shares how community-based organizations guide our work to support the oral and overall health of Latinx community members. 

Photo caption: Sharing smiles at the Latino Expo in Lynnwood this summer, hosted by the Latino Educational Training Institute (LETI). From left to right: Matt Gonzalez, Associate Program Officer; Nicole Hood, Diversity, Equity, and Inclusion Program Manager; and Alex the Tooth Fairy from the Tooth Fairy Experience. 

I’m what you’d call a people person. Whether in person or over Zoom, I love connecting with organizations across the state to learn how we can best support your efforts to improve oral and overall health. And if we can have these conversations over a cup of coffee or good meal—even better. 

Relationships are truly at the center of all we do. Arcora Foundation’s 2022-2024 strategic plan centers our work in equity to achieve good oral and overall health for all. And this plan won’t become a reality unless we take meaningful steps to center people with lived experiences in it.

Leveraging community strengths to forward racial equity.

I’ve had the privilege and joy to connect with many of you during my time at Arcora. As my current role grows, so do my opportunities to show up at community events and build one-on-one relationships with amazing Hispanic and Latinx-led organizations. 

Data shows that Hispanic children have a 50 percent higher rate of untreated decay than their white classmates. I want to stress that this disparity does not mean Hispanic communities have inherent failures. Rather, these disparities represent longstanding failures in our health care and racial justice systems, and countless missed chances to let the strengths of those with lived experience guide decision making. 

More than 500,000 people in Washington state speak Spanish at home. Without linguistically appropriate care, many may not be able to access the resources they need. In the U.S., 42 percent of undocumented individuals don’t have health insurance—compared to just 8 percent of citizens. Through programs like the SmileMobile, we work to fill the care gap for Washington’s uninsured and migrant populations. But it’s community-based partnerships that will really drive progress in our initiatives and state policymaking.

Partnerships bring about possibility.

How has Arcora Foundation supported LETI?

“Our partnership with Arcora Foundation has allowed LETI to have a more extensive outreach within the community by offering additional services in high demand. Arcora supports our community programs, events, and programs that help ensure that we can continue our work within the community. 

“In our Latino community, it’s no secret that there is a considerable gap when it comes to dental resources as well as other health resources. That’s why we were more than happy to say “yes” when LETI was offered the opportunity to host the SmileMobile van at our Lynnwood location. 

“Oral health is such an essential aspect of overall well-being, and it was an excellent opportunity for our community to get started in their oral health journey after many years of not having the opportunity to see a dentist.”  

What advice do you have for other funders looking to support community-based efforts? 

“Don’t hesitate to reach out to us. Small organizations are often passed over because it can be harder to connect with them, as we have limited staff and space, unlike larger organizations. Our advice is to be persistent, patient, and flexible in connecting with organizations that work hand-in-hand with the local community—a community that larger organizations may not be able to reach. 

“Likewise, small organizations shouldn’t be afraid to reach out to larger organizations or funders with the needs of their community. Often, larger organizations are looking to be more involved in the community but don’t know how to do it. Be diligent in advocating for your community because no one will understand it better than you. 

“Thank you to Arcora Foundation for the support and trust in community programs and outreach. Organizations like yours help LETI continue to work within our community to help educate, empower, and support those who need it most!” 

Shared goals for positive change.

In this work, I’ve learned that “you must go slow to go fast” are words to live by. Building valuable, two-way relationships takes time. Once those relationships are formed, we can be more efficient in our shared goals and desires for positive change. This is especially true when the perception might be foundations and grant makers have unbalanced power dynamics or covert agendas. Many of our deepest partnerships have grown over years if not decades. In this time, we’ve learned to listen with an openness to change—and have community expertise guide how the relationship develops. 

I look forward to meeting with more of you—and perhaps sharing some good coffee and food in the process. If you have any questions or ideas on how we can support your work, don’t hesitate to reach out to me at MGonzalez@ArcoraFoundation.org.  

About Hispanic Heritage Month

Hispanic Heritage Month (HHM) takes place September 15 to October 15 every year as a time to recognize and celebrate the many contributions, diverse cultures, and extensive histories of the American Latino community. According to the U.S. Department of Education, 2022 is focused on “Building Prosperous and Healthy Communities.” Arcora Foundation honors the diverse people and cultures who make up Washington state’s Latinx communities in our work to build healthier futures for all, with no one left behind.