December 2021 Board of Health Meeting - Ontario Seniors Dental Care Program - Status Update Information Report

SUBMITTED BY:

Oral Health Department

DATE:

December, 2021

SUBJECT:

BACKGROUND

In the fall of 2019, the Ministry of Health launched the Ontario Seniors Dental Care Program (OSDCP) to improve access to regular dental care for low-income seniors. Locally, the Windsor-Essex County Health Unit (WECHU) is implementing the OSDCP through the Leamington and Windsor oral health clinics and in partnership with the Southwest Ontario Aboriginal Health Access Centre (SOAHAC). The OSDCP provides free dental care to low-income seniors who are age 65 years and older, and have no access to other dental benefits.

Services covered under the OSDCP include:

• Preventive services (e.g., cleanings)
• Restorative services to repair broken teeth and cavities (e.g., crowns)
• Oral surgery services to remove teeth or abnormal tissue
• Endodontic services to treat infection and pain (e.g., root canals)
• Periodontal services to treat gum conditions and diseases
• Dental prosthetics (prosthodontic services), including dentures (partially covered)

In order to be eligible for the OSDCP, seniors must also have an annual net income of $22,200 or less, or a combined annual net income of $37,100 or less for senior couples (one or both people aged 65 or older). Lastly, the program is restricted to those who are not covered by dental benefits, including private insurance, Ontario Works, Ontario Disability Support Program, or Non-Insured Health benefits.

CURRENT INITIATIVES

The WECHU began to operationalize the OSDCP protocols in January 2020 with an 8:30 a.m. to 8 p.m. clinic in its downtown Windsor office and an 8:30 a.m. to 4:30 p.m. clinic at its county location in the downtown core of Leamington. The OSDCP funding currently supports three dental assistants, three dental hygienists, 1.5 dentists, one part-time denturist, two clerks, one manager and one health promotion specialist. With early implementation hindered by service alterations caused by COVID-19, the clinic has now resumed full operation and is being promoted throughout the region through the WECHU.org website, a local magazine targeting those over the age of 55, and referrals from partnering agencies.

Prior to the WECHU’s implementation of the OSDCP, the Oral Health Department’s clinic exclusively treated eligible children and youth (under 17) who qualified for the Healthy Smiles Ontario (HSO) program. With the seniors program now in full operation servicing 810 unique clients in 2021, the proportion of WECHU dental clients is now split relatively evenly between the two client groups.  Although the characteristics of the clients between the two programs are quite different, the types of treatment offered to clients under both the HSO and OSDCP are similar with the exception of certain services offered exclusively to seniors (i.e., dental prosthetics). The total number of procedures and appointments for both programs are outlined in Table 1 below:

Table 1: Services Offered to Oral Health Department Clients (January 1st – November 29th, 2021)

* Refers to number of appointments rather than individual procedures

With respect to the figures in Table 1, the WECHU anticipates the need for services will continue to increase for the senior population as only an estimated 22% of all eligible seniors in Windsor and Essex County have accessed the program to date.

Future Plans

After its first year of full operation of the OSDCP, ongoing planning regarding the best staffing model, space utilization, and resource allocation continue to be a priority of the WECHU management and leadership team. Currently, the clinics are booking appointments approximately 2 months into the future for appointments with our dental hygienist or denturist and potential for up to 5 months to see a dentist for treatment. Future directions aim to improve this wait time through a number of different program modifications:

• Exploring the provision of service in Long-term Care Homes:
  • A needs assessment survey will be distributed for those residents of long-term care homes to determine whether or not expansion into this setting is appropriate and feasible given the current funding provided.
• Expanding Clinic Capacity:
  • One large dental operatory will be split to provide an additional space for client service.
• Increasing the number of appointment times:
  • Reducing the requisite time between appointments by enhancing air filtration to allow for more appointment times throughout the day.
• Improving efficiency of professional staffing resources:

Decreasing wait times for services which can only be completed by dentists by increasing denturist time.