This resource guide is the result of a year-long partnership between Penn Dental Medicine and the Lakeshore Foundation in Birmingham, Alabama.  With funding from Carequest Oral Health Research Institute, we worked together to develop a collaborative approach to identifying and removing barriers to dental care for people with disabilities in the Greater Philadelphia area.   We hope these resources will help support access to care.

— Dr. Miriam Robbins, Director, Care Center for Persons with Disabilities

 Transportation Services for People with Disabilities

Resources to Assist with Costs of Transportation

  • Medical Assistance Transportation Services (for Medicaid recipients)
    • Non-emergency medical transportation at no cost to PA residents who receive medical assistance and have an unmet transportation need. Cites dental services.
    • Requires an application process to the county office: http://matp.pa.gov/CountyContact.aspx
    • MATP picks people up at the curb. If the person’s disability or limitations keeps them from getting to the curb, MATP is required to provide door-to-door service, when the need is medically verified.
    • MATP eligible child, under 18, can be accompanied by a parent or guardian at no cost.
    • For others, someone may accompany you on a trip when independent travel is not possible due to age, disability, language barriers, or when an escort is verified necessary for you to get medical examinations and treatment.
  • PA Find My Ride: programs to make transportation accessible and affordable to everyone. Public transportation services are available in every county including:
    • Shared ride service in all 67 counties
    • Fixed route bus service in 49 counties
    • Fixed route rail service in Philadelphia and Pittsburgh
    • Find My Ride application for free or low cost programs for seniors, persons with disability and low income individuals.

 

Reimbursement Resources

  • National Foundation of Dentistry for the Handicapped links persons with disability and aged people who cannot afford treatment and are not eligible for public aid to dentists in their communities. NFDH is affiliate of the American Dental Association and state and local dental associations.

Pennsylvania Medicaid Waivers

American Dental Association– State Level Data

  • ADA Health Policy Institute has developed state-level data to guide health organizations, state legislators, and other health researchers in policy reform.
  • Sources include reports, interactive dashboards, and journal articles, to understand the dental care landscape of your state.

Delta Dental Foundation develops and enhances partnerships and programs to improve health equity in oral and overall health. Areas of focus include increasing dental access to underserved and high-risk populations; identifying and reducing health disparities related to oral and overall health; providing educational programming; providing scholarships and awards to dental students; and offering continuing education programs for the dental profession.

  • Grants for Oral Health Access, Advocacy, Education, and Workforce Development
  • Numerous professional and patient resources posted on website

Special Care Dentistry Association is an international organization of oral health professionals and other individuals who are dedicated to promoting oral health and wellbeing for people with special needs. SCDA brings together professionals from the American Association of Hospital Dentists, the Academy of Dentistry for Persons with Disabilities (ADPD) and the American Society for Geriatric Dentistry. SCDA provides a forum for an exchange of clinical ideas and patient management techniques among members, education and networking.

  • Focus is on multiple disabilities and health conditions
  • Annual conference

WITH Foundation mission is to promote the establishment of comprehensive healthcare for adults with developmental disabilities that is designed to address their unique and fundamental needs.

  • Inclusive Oral Healthcare for People with Disabilities grantees
  • Focus is on individuals with I/DD, grant funder (until 2028)

Eastman Institute for Oral Health, University of Rochester, is committed to improving oral health care through caring, discovery, teaching and learning.

 

 

 

  • The DentaQuest Institute, Report of the National Oral Health Quality Improvement Committee: A vison for the US Oral Health System, 2023. Dr Paul Glassman,“Ten Year Roadmap to Improve the Oral Health of All Using the Tools of Quality and Accountability.”  Three objectives identified were:
    • Develop a vision for the characteristics of the desired oral health care system in 2023;
    • consider how the tools of quality and accountability can move the current system to the desired system;
    • make recommendations for actions to apply the strategies developed in this process to move the current system toward the desired vision for 2023.
  • Community Catalyst, Community Perspectives on Access, Quality, and Invasiveness of Dental Care., 2024  Community Catalyst hosted listening sessions with community members in Colorado, Nebraska and Ohio. The overarching themes were access to care, experiences with care, and invasiveness of care. Access to care exists on a spectrum that includes insurance coverage, the ability to find a dentist and get to the location where care is provided, and the ability to pay for services. Factors associated with quality of care included how patients are treated, experiences with discrimination, accessibility, affordability and respectful care. Report includes policy recommendations.
  • Delta Dental. The 2024 State of America’s Oral Health and Wellness Report. Nationwide analysis of consumer opinions and behaviors relating to oral health. Report provides insight into consumers’ recognition of oral health’s link to chronic conditions, oral hygiene’s connection to mental health, and the benefits of routine preventive care.
  • National Council on Disability, Incentivizing Oral Health Care Providers to Treat Patients with Intellectual and Developmental Disabilities, 2023.  The report examines the legislative, environmental, and system factors that are linked to expanding access to oral health care services for adults with I/DD, as these factors determine how policy, programs, and services under Medicaid are currently operationalized. Report includes recommendations for systems redesign framework that emphasizes the integration of oral health with medical health care services and coverage, and the need to incentivize providers to deliver value-based preventive health care services.
  • CareQuest State of Oral Health Equity in the United States. 2023. Largest nationally representative survey focused exclusively on adults’ knowledge, attitudes, experiences, and behaviors related to oral health. Additional reports available on website including racial disparities, oral health and mental health.

Accessibility of dental practices is a topic that does not get as much attention as accessibility in medical clinics, but there are features that apply to both, (and to any building for that matter. Below is a schematic from a US Department of Justice that illustrate spacing requirements for health care facilities that can apply to a dental practice.

Features of an Accessible Examination Room

  1. A clear floor space, 30” X 48” minimum, adjacent to the dentist chair and adjoining accessible route make it possible to do a side transfer.
  2. Adjustable height accessible examination chair lowers for transfers.
  3. Providing space between table and wall allows staff to assist with patient transfers and positioning. When additional space is provided, transfers may be made from both sides.
  4. Amount of floor space needed beside and at end of dental chair will vary depending on method of patient transfer and lift equipment size.
  5. Accessible route connects to other accessible public` and common use spaces.
  6. Accessible entry door has 32” minimum clear opening width with door open 90 degrees.
  7. Maneuvering clearances are needed at the door to the room.

Source: https://www.ada.gov/resources/medical-care-mobility/

Disability advocates and dental professionals have said that there are numerous ways to improve dental offices to be more inclusive for their patients. These improvements range from simple items that can be kept at the front desk for certain patients who need a little extra comfort to budgeting for bigger improvements that can benefit all patients. Below are some of the items that were suggested to help improve people’s experiences during their dental visits.

Items to keep at the front desk to offer to patients during their visits:

  • eye masks
  • ear plugs
  • headphones
  • radio
  • sunglasses
  • weighted blankets
  • fidget toys

Items to help improve office space:

  • Automatic flush toilets
  • Dimmer switches
  • Curtains for windows
  • Exterior canopy for protection from elements while entering and exiting the office
  • Automatic doors and sliding doors
  • Accessible medical equipment
  • Transportation CCT- Septa bus online schedules
  • Portable x-ray units
  • Instructions on how to customize a toothbrush/ adaptive devices
  • List of where to purchase affordable, adaptive devices for home use
  • List of social media outlets and channels that provide educational materials for dental hygiene
  • Specialized Care Company has multiple adaptive items available

Services recommended by dental professionals and disability advocates:

  • Having public health hygienists and physician assistants on staff who can go off site and treat underserved populations better
  • Have providers being willing and able to talk on the phone for patients and/or sign off for the public hygienists and physician assistants who are off site
  • Have a transportation guide organized by access need available at the office
  • Assist patients in completing forms when needed
  • Provide access before dental visits (telehealth visits, video experts, etc.)
  • Allow patients to provide feedback as a learning opportunity for dental professionals