City of Alexandria, Virginia
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MEMORANDUM
DATE: JANUARY 18, 2017
TO: THE HONORABLE MAYOR AND MEMBERS OF CITY COUNCIL
FROM: MARK B. JINKS, CITY MANAGER /s/
DOCKET TITLE:
TITLE
Consideration of the Release of $57,914 from Contingent Reserve for the Department of Community and Human Services to Support Oral Health Care for Indigent Residents.
BODY
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ISSUE: Consideration of the release of $57,914 from Contingent Reserves for the Department of Community and Human Services (DCHS) to support the continued delivery of oral health care for indigent residents during FY 2017.
RECOMMENDATION: That City Council approve the release of $57,914 from the FY 2017 Contingent Reserves to DCHS for subsidized oral health care provided by the Northern Virginia Dental Clinic (NVDC).
BACKGROUND: Through the approval process for the City’s FY 2017 Budget, City Council set aside $57,914 in Contingent Reserves for oral health care services for indigent City residents to be provided by the NVDC. Per Council direction, the release of these funds required staff to conduct an analysis comparing types and availability of dental services provided through the NVDC and Neighborhood Health (NH).
DISCUSSION: DCHS staff conducted a series of meetings with the NVDC, NH, the Alexandria Health Department and the Northern Virginia Health Foundation (NVHF). NVHF is the largest private funder of oral health safety net services in Northern Virginia and is a regular convener of oral safety net providers. Additionally, staff gathered information regarding: (1) types and availability of dental services provided through the NVDC and NH; and
(2) challenges, gaps, and barriers to access these services.
NVDC and NH are the primary providers of oral health care for indigent residents of the City of Alexandria. NVDC has served the Alexandria community for twenty-five years as a result of an Interjurisdictional Agreement among the City of Alexandria, Arlington and Fairfax Counties and the City of Falls Church. Adults only are referred to NVDC by DCHS’ Office of Community Services and Center for Adult Services. NH was awarded a five (5) year City contract effective FY 2015 to provide dental services for adults and children formerly served by the Alexandria Health Department. Alexandria residents self-refer to NH. The enclosed chart provides an overview of the services available, access to services, eligibility criteria, and the numbers of residents served during FY 2015 and FY 2016 (Attachment).
The demand for care exceeds the current capacity of both organizations. NVDC has one full-time dentist who conducts initial examination and develops a treatment plan. The preventative and specialized care are provided by volunteer dentists from throughout the region. Consequently, NVDC allocates a finite number of appointments for City residents. While NH can address basic dental service needs, they must rely on a limited cadre of private dentists to address the specialized dental care needs of their patients. NVDC and NH have indicated that they are currently exploring other resources that may expand their level of services and increase the number of people they can serve.
NVDC and NH have differing referral mechanisms, service delivery approaches, and capacity to meet the services demand of Alexandria residents. In light of this, both organizations agree that further exploration of a coordinated system is required, and are willing to work with DCHS, Alexandria Health Department and NVHF staff to recommend a coordinated service delivery system in partnership with the City and regional stakeholders for FY 2018.
FISCAL IMPACT: The $57,914 in funding from Contingent Reserves will enable DCHS to execute a Memorandum of Agreement with the Northern Virginia Dental Clinic to pay $25,000 towards the salary of a fulltime dentist in exchange for 375 appointments through FY 2017. The DCHS’ Office of Community Services through FY 2017 will use the remaining $32,914 to subsidize the cost of initial and emergency appointments, and dentures for adults (depending on the level of care needed).
ATTACHMENT: Alexandria Dental Service Providers
STAFF:
Debra R. Collins, Deputy City Manager
Kate Garvey, Department Director, Department of Community & Human Services (DCHS)
Stephen A. Haering, M.D., Director of Alexandria Health Department
Morgan Routt, Director, Office of Management & Budget
Suzanne T. Chis, Executive Deputy Department Director, DCHS
Lesa Gilbert, Director, Center for Economic Support, DCHS
Raphael Obenwa, Fiscal Officer III, DCHS