Board of Health

Skokie Board of Health December 8th, 2016 Present Absent Excused Mr. Abbasi Dr. Shim Mr. Pandya Dr. Vernon Dr. Dave Dr. Sood Dr. Prince Dr. Polin Dr. Drachler Ms. Urbanus Ms. Topouzian Dr. Gaynes Dr. Usman Dr. Varma Ms. Jones Thorne Dr. Williams Ms. Nickisch Duggan Dr. Werner Mr. Nidetz Guest, Humia Ahmed, Oakton Community College Dr. Catherine Counard, Director of Health Mr. David Clough, Staff Call to Order - The meeting was called to order at 7:05 p.m. by Dr. Drachler, Chairman. Approval of Minutes – Minutes from the November meeting were reviewed and approved. Skokie Oral Health Needs Assessment, Dr. Larry Williams (a copy of the presentation is attached) Dr. Williams presented on the Oral Health Needs Assessment he performed for his Master’s in Public Health internship. The four areas of focus were long term care facilities, school districts, the Niles Township Food Pantry, and local dentists through the Chicago Dental Society. On a national level, Illinois has more people below 200% of the federal poverty level than the national average. The amount of dental care available is also declining. One of the factors Federally Qualified Healthcare Centers (FQHCs) use to substantiate their need is the percent of the population below 200% of the federal poverty line. It is roughly estimated that only half of Americans have dental insurance. Dr. Counard pointed out that we have 18,000 residents below 200% of the federal poverty level in Skokie according to the census. Long Term Care Facilities The first phase of the project involved meeting with the Administration at the six long-term care facilities in Skokie. Dr. Williams planned to survey residents to determine their dental health needs. Five out of the six long term care facilities (LTCFs) either had a dentist on staff or a dentist who visits the facility. The other facility was a short term physical rehabilitation facility. Dr. Williams shared a study that showed that the average amount of time spent on oral care in an assisted living facility was 30 seconds. CNAs also frequently do not change gloves between oral care and other activities. (Note from Editor Dr. Counard: Dr. Williams offered to provide instruction on dental care to CNAs at the facilities, which was enthusiastically received. He plans to have the Midwestern dental students assist with this project). The survey of residents was based on Skokie’s community health survey and the Geriatric Oral Health Index. The Geriatric Oral Health Index was created in the 1980’s and validated in the 1990’s. One facility in Skokie did not participate in the survey, largely because many of the residents have severe dementia. The return rate for surveys from LTCFs was impressive at 227/300 (76%). The vast majority of respondents did not rate access to oral health care as a significant area of concern, likely because dental care is provided at the facilities. Half of the seniors rated their oral health as less than very good and a quarter of respondents stated that they limit their food choices due to oral health problems. Schools Students are required to have an oral health screening in Kindergarten, 2nd grade, and 6th grade. More Kindergarteners and 6th graders tend to have the exams completed: Kindergarteners because it is their first opportunity to be screened and 6th graders because they are evaluated for braces, especially since braces are now covered by Medicaid. All five school districts contract with dental vans for cleanings and sealants. The school nurses were not aware that the two new Federally Qualified Health Centers serving the Skokie area provide dental care for children who do not have insurance or are covered by Medicaid. Dr. Williams provided information to the school staff about Asian Human Services and the Erie Evanston/Skokie Family Health Center. Local Dentists Through the Chicago Dental Society 42 dentists were identified in the 60076 and 60077 zip codes. These dentists were sent up to three letters asking if they provided discounted or free services and if they were willing to accept new patients for these services. Nineteen of the 42 offices responded. We learned that some of the non-respondents were orthodontists who the survey would not apply to. Of the dental offices that responded eight stated that they provide discounted services. Seven provide free care through the Holocaust Survivor Program and Donated Dental Services/Dental Lifelines Programs. Twelve of the offices stated that they would be willing to accept new patients without dental insurance. This information will be used to increase the number of providers on the Health Department’s Dentist Referral list for those who are uninsured or underinsured. Food Pantry According to NHANES food insecurity is linked to other chronic illnesses including oral health. At the Niles Township Food Pantry 34 out of 50 (68%) surveys were collected to assess oral health needs in this population. Twelve respondents reported having some type of tooth problem in the past six months and half of these individuals did not seek help for these problems. Three quarters of respondents report limiting food choices due to oral health issues. These responses indicate that there is a high oral health care need among our low income food insecure population. #507084 Summary This project provided valuable insight into oral health care needs in Skokie. Seniors in Long Term Care Facilities had better access to oral health care than expected. Low income residents who use the food pantry are a definite area of need. Two immediate benefits of the project are increasing the number of dentists on the referral list and making sure school nurses knew about resources at our Federally Qualified Health Centers. A short discussion followed. Dr. Shim asked if Asian Human Services provided complete dental services or only emergency services. Dr. Williams responded that both urgent and rehabilitative care is provided. Within a week of the Niles location of Asian Human Services opening there was a two week wait for dental care. Dr. Shim reported that at Cook County Hospital just 30 to 35 patients are accepted each day for dental care on a first come first serve basis. She advises patients to have three people call simultaneously to get in. The slots fill within the first five minutes of the phones being open. This is just for tooth extractions. Dr. Drachler asked why so many people have cavities when the water is fluoridated. Dr. Williams suggested that the effect of acidic beverages may be counteracting the effects of the fluoride. Dr. Drachler stated that it may also be linked to drinking bottled water which contains no fluoride. Dr. Williams stated that significant systemic links exist between oral health and other health issues. Gum disease is linked to diabetes and poor dental health is linked to premature childbirth among pregnant women. Chair’s Report Dr. Drachler requested that Dr. Shim give a brief introduction, and she gave a brief summary of her personal life and professional experience. Dr. Shim works at the Fantus Clinic and the Cook County Board recently approved plans to build a new facility on the site at Polk and Damen. Dr. Drachler pointed out that the clinic was named after Richard Fantus who was the first doctor to bank blood in the United States. Health Director’s Monthly Report – a copy of the report is attached Highlights included: • Visit to the Sikh Gurudwara in Palatine • Homebound and School Flu Shots • Great American Smoke Out at Oakton Community College • Rethink Your Drink for Mather Lifeways at the Skokie Public Library • Assyrian Community Health Needs Assessment #507084 Dr. Drachler reported that Phillip Morris is now promoting vaping instead of traditional cigarettes because that market is increasing. The Surgeon General has reported that vaping is the most likely route for teenagers to be introduced to tobacco. Dr. Werner asked how the department identifies homebound flu shot recipients. Dr. Counard answered that we advertise the service in NewSkokie, identify residents who have difficulty at the community flu shot clinics, or get referrals from the Human Services division and the Meals on Wheels program. Dr. Drachler asked if IPLAN meetings would continue to be held on the third Wednesday of each month. Dr. Counard responded that a list of dates for future IPLAN meetings would be sent out in January. Old Business: Dr. Drachler asked if Mr. Clough had found a connection between septicemia and surgical procedures as asked at the last Board of Health presentation. Mr. Clough responded that unfortunately the hospital discharge data is too limited to answer that question. Dr. Drachler then shared an article on the pitfalls of promoting low fat diets instead of restriction of total calories. He held this up as a good example of how the Federal government sometimes sets goals with good intentions but misses the primary issue. Ms. Nickisch Duggan asked if the State Board of Health was still at risk to be abolished. Dr. Counard replied that no further efforts had been made to dissolve the Board. New Business: No new business. Meeting adjourned at 8:16 PM. The next meeting of the Skokie Board of Health will be: Thursday, January 12th at 7:00 PM Village Hall Conference Room A #507084