Successful Model for Rural and Underserved Communities
Northern Dental Access Center
Target Population: Families with low incomes
Geographic Area: Rural, northwestern Minnesota
Description: This dental clinic serves clients from some of the poorest counties in the state. One hundred percent have low incomes. Half are children.
Rural, northwestern Minnesota is an area of high poverty and central to three major American Indian reservations. Thousands of people in the region are eligible for Medical Assistance or MinnesotaCare. Before Northern Dental Access Center, most were forced to travel hundreds of miles for dental appointments and others simply went without care or found themselves in an emergency room when pain became unbearable.
Staff are trained in understanding poverty and several staff members are emerging from poverty issues of their own. Rather than adhering to the common three-strikes-you’re-out approach to appointment failures, Northern Dental Access Center staff work with patients one-on-one to create strategies for success.
Staff focus on the individuality of all patients by taking time and paying attention to what the patients are experiencing. Sometimes it is anxiety because their last visit to a dentist didn’t go well. Sometimes dental jargon is intimidating. Sometimes lying in a dental chair resembles the experience of being abused or sexually assaulted. Sometimes they just feel like there is no hope.
Children’s furniture, family activities, state-of-the-art equipment, the absence of stigma and even the artwork reflecting the native culture of the region, come together to create a place where vulnerable and voiceless families are welcomed and treated with respect.
Northern Dental Access Center also seeks patient feedback to hear directly from those they serve about how to better meet their needs and develop procedures that will maximize success.
Multiple partnerships working collaboratively with Northern Dental Access Center support families facing multiple challenges.
- Beltrami County Public Health nurses provide child/teen exams and immunizations on site.
- A regional consortium of mental health providers administer mental health screenings for children; they refer families to community mental health services so intervention can occur during these critical early years.
- Community Resource Connections has a satellite office at the clinic with insurance counselors to help families through the maze of enrolling and staying enrolled in public health plans.
- Central Minnesota Pediatric Dentist is on site quarterly to provide pre- and post-operative visits for children in need of surgical care. This saves families two of the three trips required to St. Cloud, Minnesota, which can be three or more hours long each way.
- A nutritionist is on site twice monthly to provide families with fun and easy healthy living and eating tips.
Bemidji is a regional center, so a trip to the dentist may be combined with a trip to larger stores and government services buildings, which also means many family members come along. The waiting rooms are ready and welcoming: Children can play, others read or watch TV. Some families stay the entire afternoon while everyone has a turn seeing a dentist. Patients report that this welcoming environment is different from any place else they go to receive help.
Northern Dental Access Center is also a resource for the dental community, providing a high quality place for volunteering, teaching and workforce training. Eighteen dentists from around the state provide care and all report that the rewards are sweet.
Background: Frustrated with the lack of dental access for vulnerable citizens and the impact on community health, supporters began building a new model of care in 2002. Now Executive Director Jeanne Edevold Larson was a business consultant through Bemidji State University’s Center for Research and Innovation when she helped spearhead fundraising and support for a critical access dental facility. The dream of the community and the board of directors was a dental home for people in need that acknowledges the challenges of poverty, provides an integrated approach to family health, and welcomes children—to build new generations of healthy people. Their vision embraced a noncompetitive approach making private practice dentists critical to success.
After seven years of detailed, communitywide planning and collaboration building, the passion and commitment of local agencies, employers, dentists and educators created Northern Dental Access Center in Bemidji, Minnesota. Dozens of statewide funders invested more than $1 million for clinic start up and more than 20 regional agencies still make up the community advisory group.
The community dental clinic opened January 2009. At the end of that first month Larson said, “Every day that we’ve been open we’ve had subzero temperatures, blizzards, school closings, late starts and still our patients come. We are humbled.” Two years later, more than 6,000 patients with low incomes from the area now have a local dental home; more than 1,000 are waiting. With more than 17,000 people in the area eligible for care, this clinic will be needed for years to come.