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Bemidji dental clinic for low-income families should be open this fall

A dental clinic to serve low-income Beltrami County families should open this fall, says Beltrami County Health and Human Services Director Mary Marchel.

A dental clinic to serve low-income Beltrami County families should open this fall, says Beltrami County Health and Human Services Director Mary Marchel.

The Mississippi Headwaters Area Dental Health Center is in final negotiations with MeritCare Clinic of Fargo, N.D., for use of the former Womack Eye Center on Anne Street, Marchel said. The Eye Center, now owned by MeritCare, is moving farther west to a new facility near the clinic's Urgent Care Center.

Plans call for the dental center to open in October, but not staffed to full capacity for at least a year, Marchel told Beltrami County commissioners last week.

Marchel cited state figures that in 2003, more than 391,000 Minnesota children under age 21 were enrolled in Medicaid and only about 126,000 received any dental visits.

"In the northwest region of Minnesota, there are more than 6,000 children from birth to age 19 enrolled in MinnesotaCare and Medical Assistance -- 16 percent of all children and almost double the state average," she said.

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"Beltrami County residents on public assistance made more than 4,600 dental visits outside the area," Marchel added. An estimated 24 percent of residents in the area report no visits to the dentist in the past year -- with many of those people forced to seek episodic treatment for dental pain or infection from hospital emergency rooms.

Beltrami County is designated as a dental underserved area with only 14 dentists serving a population base of more than 40,000 people.

Part of the problem is that many local dentists won't see patients on public assistance because reimbursement for services through the state program nowhere near covers the cost of providing the service.

The state has authorized critical access dental clinics across the state where, by volume of services, public assistance care does break even. The new Bemidji clinic will carry that classification, with Park Rapids the nearest similar facility.

The Mississippi Headwaters center plans on opening with four or five treatment areas with one full-time dentist, a hygienist and a dental assistant. Also hoped is to fill out services with part-time or volunteer dentists as needed, Marchel said.

"Working at six to eight patients per hour, it is estimated that 45 patients will be seen per day or more than 200 a week," she said. "This means that during full operation, the clinic can expect 10,000 patient visits per year."

Patients in the first year will be people on subsidized health care plans, such as MinnesotaCare, Medicare, Medical Assistance or a county health program, she said.

County Public Health Services will also be involved, Marchel said, as a on-site public health outreach person will help screen dental patients and make referrals for other health problems. They will also help clinic staff with calls on missed appointments, Marchel said.

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They can do health screenings such as child immunizations, well-child exams and blood pressure checks. A case management approach will serve a population that is in need of more intense monitoring, follow-up and personal care, Marchel said.

"The doctor will probably be looking into the mouths of those who have never seen a dentist before," said Commissioner Jim Heltzer. "It will increase our costs under MinnesotaCare and Medical Assistance at least the first year."

"But it will be better to see them in the clinic rather than in an emergency room," Marchel said.

Heltzer agreed, saying that "this will help people who don't often get a hand up."

The formal structure to run the center is now being put into place, Marchel said, starting with the hiring of Jeanne Edevold Larson to direct the dental center. She previously served as a consultant to the advisory council that has spearheaded the project for several years. Edevold Larson's first day was April 15.

"Tax-exempt non-profit status has been awarded by the Internal Revenue Service," Marchel said. "More than $450,000 in start-up funds have been secured. We have donated, gently used dental equipment valued at $75,000, and we've hired an executive director."

A formal board now oversees the center, led by Bemidji dentist Dr. John Lueth as president. MeritCare's Warren Larson serves as vice president and Colleen Falk as secretary/treasurer. Also on the board are Marchel, Robert Engel, Cathy Gunvalson and another dentist, Dr. Laura Schwindt.

The center has and is seeking a number of grants, and a new grant program through the state Legislature can be tapped, Marchel said. A number of community groups and individuals guided the project through its development.

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Some remain, such as the Bemidji Sunrise Rotary Club, which plans to set up a children's play area in the new dental center.

"Still remaining we have to recruit professional staff," Marchel said, especially that of the full-time dentist. "We are working very hard in the next month or two to recruit. And we will need to procure and install equipment and set systems up."

Other needs include a panoramic X-ray unit, four months' payroll for office administration support and incidental office supplies, she said. Finally, staff will start scheduling appointments.

"It is anticipated that it may take up to two years to see full capacity realized," Marchel said. "Reimbursement rates will cover most of the cost of operation, with additional investments secured from our community partners."

It is expected the dental center will be self-sustaining in three years, she said.

Dental hygiene is a key component, said Commissioner Jack Frost, who encourage the clinic to also educate patients -- especially children -- on how to keep teeth clean and prevent dental problems in the first place.

Bemidji School District staff will help do that, Edevold Larson said. "When the clinic is sustaining we'll have help to do that, but our first goal is to get the doors open."

"This is a well-thought-out, well-planned , well-executed project that shows great promise for those (low-income) people," Frost said.

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