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Northern Dental Access Center marks first year with expansion

The Northern Dental Access Center marks its first anniversary with an expansion project. Standing in the center's Bemidji Sunrise Rotary Family Fun Area are, from left, Executive Director Jeanne Edevold Larson, Treatment Coordinator Lisa Mattila and Clinical Coordinator Laurie Moore. Pioneer Photo/Brad Swenson

The Northern Dental Access Center helped put smiles on the faces of more than 2,000 low-income people, many of them children, in 2009, its first year.

And now, entering its second year, the center this week opens more dental suites in an expansion to increase the capacity of people it can serve.

By the end of this week, the center will have nine fully functional dental operatories and two overflow suites for dental hygiene and checkups.

"The patients are coming from about a 100-mile radius, with 60 percent from about a 30-mile radius," Jeanne Edevold Larson, center executive director, said last week in an interview. People from Bagley and Fosston to the west and Cass Lake to the east are using the new service.

The center is in the former Womack Eye Clinic to the north of North Country Regional Hospital.

Forty-five percent of the patients are children, she said. "We had hoped that to be more, and our goal this year will be to try and encourage parents to bring children in. ... The children are our priority."

Ten percent are senior citizens, she added. Sixty-five percent of the patients are female.

The Northern Dental Access Center took years to bring to fruition, involving a number of community partners and beating the bushes for start-up grants and legislative funding.

Its goal is to provide dental services to an underserved population of low-income and poor people who otherwise end up in hospital emergency rooms with severe dental problems. Because of low reimbursement rates from state public programs, many private dentists can take only so many public assistance patients, leaving the rest to seek more costly emergency treatment.

The Dental Access Center isn't a free clinic -- it also depends on state reimbursement through public assistance programs Medical Assistance, MinnesotaCare and General Assistance Medical Care.

The latter, GAMC, is a program that ends March 1 because of Gov. Tim Pawlenty's unallotment last summer of $2.7 billion from the state budget, but less than 10 percent of the center's patients are on that program. Larson said the cut will affect the center, but not significantly.

Also unallotted is critical access dental payments as of July 1, which could affect the center's business model, but still the center will adapt.

"The great thing about having such a broad base of support is that no one blow is going to derail us," she said. "We have so many people who have such a huge investment in this being successful that we'll find a way."

The center is working with the Beltrami County Health and Human Services Department and Community Resources Connections to screen center clients for other health issues and to refer them to other non-profit agencies for services they may need.

Whether the concept is working will take time, Larson said. It is setting public health benchmarks to measure outcomes, which needs time to develop, she said. But anecdotally, it seems to be working.

"People report, 'I haven't missed work as much,'" Larson said. "Or, 'I was able to get the job because my two front teeth,' we put them back. We fixed the partial."

Larson recalls one man testifying before the Beltrami County Board about the center: "I can finally kiss my wife again," he said.

"It's tough to connect the dots from us being here to wow, this is a healthier community, but we're collecting enough evidence that will build a strong case," Larson said. "We certainly have been showered with a lot of gratitude from all sectors of this community, including employers and teachers and parents and the kids themselves - and frankly, we just got started."

The center started seeing patients Dec. 15, 2009, with a limited schedule to work the kinks out. It became operational last January, and has seen more than 2,000 patients - increasing its list by 10 to 15 patients a day.

Originally envisioned as open one or two days a week on a shake-out cruise, the center quickly became a five-day-a-week operation. Larson said the center still lacks what it has as an original goal - a full-time staff dentist. But its current model, contracting with some dentists and seeing a lot of dentist volunteers, seems to work.

A typical day sees one or two dentists on duty, Larson said, with each dentist having two chairs. Patients are assigned usually with one chair for heavy-duty operative chores and the second for new patient exams, denture checks and the such.

"They also work with one hygienist, with the hygienist cleaning teeth and the dentist pokes in and does an exam," Larson said.

With the new expansion, the center will have the capacity for three dentists, three dental hygienists all the time, she said. "I'll have to hire more dental hygienists and dental assistants, but that's a good problem."

The center operates with state-of-the-art equipment, and many dentists in the region like to volunteer just to gain new best practices experiences with the new equipment, Larson said. Plus, the center's records are totally digital, something that dentists also want to see how it works.

"I would like two full-time staff (dentists), folks who are employees of ours, that take on some leadership," she said. "I have a couple in the queue that are interested."

What the center has become is a place with core staff, building a team approach, which works with the 14 dentists that come and go regularly.

"They are the faces to the patient base rather than the dentists," Larson said of the staff. "They may not see the same dentist more than once, but you're always going to see this group who know you and your kids."

Aside from the public health aspect, the center also benefits the community as a new business, Larson said.

The center got off to its start with $650,000, and now projects a $1.2 million in revenues for its first year.

A little less than half that is being paid out in non-dentist payroll. "Our core staff are people who live here right in Bemidji, and they're not minimum wage jobs," Larson said. "These are professional jobs with full benefits, health and retirement, in a nice, family-friendly place to work."

Said Larson: "2010's going to be great -- we're so proud of this place."