Connor W. Norwood

State policy environment and the dental safety net: a case study of professional practice environments’ effect on dental service availability in Federally Qualified Health Centers

OBJECTIVES To determine whether and to what extent the state policy environment for the dental hygiene workforce affects the availability of dental services at Federally Qualified Health Centers (FQHCs). METHODS We examined data drawn from the Uniform Data System on 1,135 unique FQHC grantees receiving community health center funding from the U.S. Health Center program between 2004 and 2012. The Dental Hygiene Professional Practice Index was used to quantify variations in state policy environment. We then examined the influence of state policy environment on the availability of dental care through generalized linear mixed-effects models. RESULTS Approximately 80% of FQHCs reported delivering dental services. We consistently observed that FQHCs with favorable levels of state support had the highest proportion of FQHCs that delivered dental services, even more so than FQHCs with extremely high support. FQHCs located in the most restrictive states had 0.28 the odds of delivering dental services as did those located in the most supportive states. CONCLUSIONS The state policy environment for the dental hygiene workforce is likely associated with the availability of dental services at FQHCs. The greatest proportion of FQHCs delivering dental services was found in states with policy provisions supporting professional independence in public health settings. Nevertheless, additional research is needed to understand the specific mechanism by which these policies affect FQHCs.

Administrative Challenges to the Integration of Oral Health With Primary Care: A SWOT Analysis of Health Care Executives at Federally Qualified Health Centers.

Inadequate access to preventive oral health services contributes to oral health disparities and is a major public health concern in the United States. Federally Qualified Health Centers play a critical role in improving access to care for populations affected by oral health disparities but face a number of administrative challenges associated with implementation of oral health integration models. We conducted a SWOT (strengths, weaknesses, opportunities, and threats) analysis with health care executives to identify strengths, weaknesses, opportunities, and threats of successful oral health integration in Federally Qualified Health Centers. Four themes were identified: (1) culture of health care organizations; (2) operations and administration; (3) finance; and (4) workforce.

Fighting Prescription Drug Abuse Through State Policy: The Role of Nursing in Successful Implementation.

AbstractPrescription drug abuse has become a top public health concern in the United States in recent years. Changes in prescribing practices and the way in which health providers manage pain resulted from national quality improvement efforts in the 1990s. Most efforts to reduce morbidity and mortality associated with the prescription drug abuse epidemic occur through policy initiatives at the state level. In 2011, Indiana ranked 17th in the United States and had only implemented a few intervention and prevention strategies. However, through a coordinated effort within the state, Indiana has expanded Good Samaritan laws and adopted rescue drug policies. Furthermore, the nursing workforce in Indiana has played a critical role in the successful implementation of these new policies. Nurses across the state have provided education and training to first responders and lay persons. They have also consulted with law enforcement agencies and other organizations looking to fully leverage the potential of these new state policies. Because of their versatility and clinical expertise, the nursing workforce has and will continue to play a critical role in the successful implementation of state policy initiatives aimed at fighting the prescription drug abuse epidemic.

The U.S. Health System

The complexity of the health system continues to grow and can be characterized by more to know, do, manage, and watch for more people than at any point in history. Population health and health outcomes in the United States have been largely impacted by poorly organized and uncoordinated health care delivery. As the U.S. health system aims to improve quality, increase access, and reduce cost, the role of clinical informatics has become increasingly important. This chapter sets the foundation for understanding the importance of clinical information’s and the flow of information within the various domains of the health system as well as between these health system domains.

Policy Report: 2012 Indiana Mental Health Workforce

Assuring that mental health services are available and accessible for all Hoosiers that need them is important to reduce related morbidity and mortality and improve mental health. At the community-level, the availability of mental health services is largely based upon the supply and distribution of the workforce that delivers mental health services. Indiana’s licensed mental health workforce is comprised of psychiatrists, psychologists, psychiatric nurses, and a number of mental health professionals. A number of important issues emerge from recent data on the supply and distribution of this workforce. These issues, described throughout the document and outlined below, have been organized for the purpose of informing the agenda for mental health workforce policy in the State of Indiana. These issues emerged in objective consideration of workforce data and do not take into account perspectives of any one profession or stakeholder group.