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Contract for services to Connecticut nonprofit and for-profit health centers, with dental health professional shortage area designation, and state agencies to improve oral health and chronic disease outcomes for at-risk patients. Applicants must submit an LOI prior to applying. Funding is intended for creative medical-dental integration projects that address common risk factors for children who are at risk for tooth decay and childhood obesity, and adults at risk for oral disease and prediabetes. The grant has two components; all applicants are required to respond to Component 1, while Component 2 is optional.

The selected FQHCs will 1) collaborate inter-professionally with medical and dental teams to develop systems and workflows to identify, screen, refer, and track at risk patients to improve oral health and chronic disease outcomes, 2) increase medical and dental provider knowledge and skills to integrate oral health and chronic disease, and 3) develop a sustainability plan to ensure the continuation of the project.

The focus of Component 1 is to address the common risk factors associated with obesity and dental caries in children by developing a systematic approach to identifying at-risk children in dental HPSAs, to provide basic nutrition and oral health counseling as it relates to these risk factors, to initiate referrals to primary medical care and dietitians for follow-up when indicated, and to establish client tracking and bi-directional communications systems and payment sustainability. The three main goals are:

1. Increase the knowledge and skills of dental professionals to address common modifiable risk factors associated with childhood obesity and tooth decay through nutrition screening, counseling, and referral.
2. Establish site practice workflows, referral and tracking mechanisms, and bidirectional flow of relevant client information.
3. Institute a payment policy and billing strategy to actively monitor and recommend changes in the payment environment.

The focus of Component 2 is to integrate prediabetes screening, counseling and referral into dental settings at designated dental HPSAs by identifying adults at risk for type 2 diabetes and initiating referrals to primary medical care for follow up, as well as a referral from dental care providers to a CDC recognized, LCP. Component 2 also aims to implement a multi-faceted, innovative approach to engage dental providers to integrate evidence-based, prediabetes screening, referral and education into daily dental practice. The four main goals are to:

1. Integrate medical and dental operations to address patients at risk for prediabetes, type 2 diabetes, and oral disease.
2. Engage medical and dental providers in participating in grand rounds and trainings on the connection between oral health and type 2 diabetes prevention and management, which includes motivational interviewing and usage of a prediabetes screening tool identify adults at high risk.
3. Increase the number of bidirectional referrals between medical and dental providers for at risk adults.
4. Establish workflows and tracking systems to screen, refer, confirm prediabetes through a blood glucose test, enroll those with prediabetes into a CDC-recognized LCP, and track the number of patients who are referred and enroll who complete the program. 

Proposals much outline an innovative medical-dental integration project that improves health outcomes associated with childhood obesity and type 2 diabetes in dental settings. For information about the elements that must be addressed, see: https://portal.ct.gov/-/media/Departments-and-Agencies/DPH/dph/rfp/PDF/CT-DPH-20200903-RFPMedical-Dental-Integration-ProjectFinal.pdf?la=en#page=24