Integrated Care: Expanding the Dental Safety Net

INTEGRATED CARE: Expanding the Dental Safety Net

TABLE OF CONTENTS Charlottesville Free Clinic Dental Annex Case for Support 2024

1. Introduction 2. The Problem: Limited Access 3. The Solution: Expanding Care 4. Design and Images 5. Budget and Request for Help

Keeping All of Charlottesville Healthy For the last 31 years, the Charlottesville Free Clinic has provided free essential healthcare to uninsured or underinsured members of our community. The Free Clinic provides care through three units: Medical, Pharmacy, and Dental. A small staff operates our clinics and relies on the generosity of more than 700 volunteer healthcare professionals who treat patients throughout the year.

In 2023, we were the healthcare safety net for more than 2,600 people in our community who would have otherwise been unable to afford care. Our medical patients are treated for anything from preventative visits to cancer treatments to chronic disease management. Our dental clinic patients are seen the same day for emergency care or every six months for preventive care. The care we provide is vast and complex but personal and specific for every patient served.

However, more than 12,426 people in our area still can't afford health care or dental care.

Accessible and affordable healthcare is unattainable to many people in our community. In 2017, the Washington Post published an article, "Where are the most expensive ACA plans in America? Charlottesville." In the last seven years, this problem has stayed the same.

Today, healthcare costs continue to grow faster than inflation.

A Day in the Life.

Juan is 45 years old and works an hourly job as a janitor at a local school. He makes about $31,200 a year but receives no benefits. Juan pays his bills and taxes and is a good community member. However, he was not going to the doctor or dentist because he could not afford insurance in the private market. Because of delayed dental care, Juan has significant tooth decay and subsequent health issues.

Juan discovered the Free Dental Clinic last year and now prioritizes his oral health. He shared, "I am so grateful for the care that I couldn't find anywhere else."

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The Tooth of the Problem The Free Dental Clinic has consistently seen remarkable demand for services. The dental clinic provides direct access to acute dental care, oral hygiene, and oral education for low-wealth, uninsured community members. All services are free of charge for our patients.

In 2023 we treated 760 new dental patients

In 2021, Virginia expanded Medicaid coverage to adult dental services. While this is an excellent policy advancement, the reality is that hardly any private practice dentists in our area accept Medicaid. The Free Clinic remains Charlottesville's only dental safety net and provides services to Medicaid-eligible individuals. With no other option for care, these community members are wholly reliant on the Free Clinic for dental needs.

Last year, we provided care for 1,534 unduplicated dental patients during 3,559 visits. While our impact has been tremendous in the lives of our patients, there are still tens of thousands of people in the greater Charlottesville area who don't have dental or health insurance.

Within our current space, we can only treat 12% of the area population that needs our care.

Our Dental Clinic waitlist and walk-in clinics are clear red flags that the community needs more dental services, which we can't provide in our current space at Rose Hill Drive with only four dental operatories.

THE VALUE OF DENTAL CARE WE PROVIDED FOR FREE LAST YEAR WAS $1.7 MILLION 2

A PATIENT, DOCTOR, DENTIST, AND PHARMACIST ALL UNDER ONE ROOF MAKING HEALTHCARE EQUITABLE. Years ago, after the closing of dental safety net clinics at UVA and the local health department, the Free Clinic became the only source of acute care outside the emergency department for low-income individuals. We continue to serve as the only safety net provider in the area.

Our goal is to expand our services, and the majority will be provided under one roof. As we build the dental clinic at the Wellness Center, we are making a concerted effort to provide all Free Clinic services in one central location.

The opportunity to integrate care between medical + dental is within reach.

Our clinics are making huge strides toward a more equitable healthcare program in Charlottesville, and we invite you to help.

Our Focus on Overall Health Oral health is directly related to our patient’s medical wellbeing. Oral disease can lead to adverse health consequences, including tooth loss in people with diabetes and preterm births in pregnant women. Research also shows connections between oral disease and cardiovascular disease: individuals with periodontal disease are nearly 200% more likely to suffer a fatal heart attack and 300% more likely to suffer a stroke than those with good oral health. Most oral diseases tend to be progressive and cumulative without intervention.

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We Need Your Help.

Will you consider an additional gift as we expand our dental and integrated care practice?

There are initial build-out costs that will allow us to provide an additional 2,300 patient visits in the first year.

There are ongoing operational costs to support this growth, please also consider committing to a multi-year gift to help us provide 9,500 patient visits over the next four years.

Cost Allocation

2024

2025

2026

2027

New Building Renovation

$292,000

Dental Equipment

$274,000

Dental Equipment Donated

-$60,000

Dental Program Expenses

$870,000

$1,003,000

$1,367,000

$1,431,000

$1,376,000

$1,003,000

$1,367,000

$1,431,000

Total

Impact Projected Number of Dental Patient Visits

3,655

5,955

8,892

9,500

Cost per Visit for the Dental Clinic

$376

$168

$154

$151

Projected Number of Dental Patient Visits 10000 8000 6000 4000

6

2000 0

2024

2025

2026

2027 5

David Ding has been a bartender at the Aberdeen Barn restaurant for many years. With two children and no health insurance, David and his wife, Verna, could barely cover the family’s routine medical care. However, surgery a few years ago for a life-threatening aneurysm put the family in debt. By the time they found the Free Clinic, both were suffering from the effects of high blood pressure, and David had an abnormal heart rhythm. Unable to afford preventive dental care, David had developed extensive dental decay, which was worsening his heart issues and affecting his overall health.

Verna and David Ding are prototypical Free Clinic patients—middle-aged adults with complex, extensive medical needs and no health insurance. Without ongoing support for their chronic health problems, their quality of life and employment is compromised. David and Verna need regular blood pressure checks, lab tests, and medication. David needs a CT scan every two years to monitor his aneurysm repair site, medication, and extensive dental work. Verna’s diabetes has been difficult to control, even though she is diligent about diet and exercise. She needs regular checkups and lab tests, as well as dental exams and foot care. She must take several expensive medications and needs a glucometer to self-monitor her blood sugar levels.

Fortunately, the Free Clinic can provide almost all of the Dings’ health care services for free through our medical and dental clinics and medical referral network. The Dings’ situation helps illustrate the complexity of providing health care and the reason why the Free Clinic is constantly growing and evolving.

901 Preston Ave, Suite 301, Charlottesville, VA 22903 www.cvillefreeclinic.org development@cvillefreeclinic.org