Policymaking and Dental Care in the Health Reform - Assignment Example

? Policymaking and Dental Care in the Health Reform Evaluation of the process of agenda setting as it relates to policymaking Agenda setting is often considered the initial stage of the policy-making process. During the agenda-setting process, problems are identified, translated into issues and the issues prioritized in terms of urgency and importance. For a problem to pass the test for becoming an issue during this stage, it must rise above a personal issue and be considered a social or public problem. Agenda setting stage is crucial in determining what problems deserve policy solutions and resolution at the present or prevailing situation. Policymaking as a multidimensional and dynamic process is significantly influenced by the values of those individuals involved in the establishment of the policy agenda (Cohen, 1999). Problem-centered policymaking processes such as dental health promotion policies are significantly influenced by agenda setting stage in which the problem is identified, policies formulated, policy alternatives identified and policy goals aligned with policy adoption process. In public policymaking, once a problem such as deteriorating dental or oral health attains the issue status, its urgency and importance must be able to compete with other issues with health care setting for attention and resources. Active agenda consists of those issues to which decisions makers are applying and pushing for resources. It should be noted that not all issues reach the active agenda and appear on the lower section of the priority list, leading them for consideration for funding in the future (Cohen, 1999). Therefore, the agenda setting stage must be effective enough to ensure that the proposed policy can compete effectively with other issues requiring funding from the government. For example, the issue of dental health promotion in the agenda setting in the Medicaid program must be able to compete sufficiently with other health issue to guarantee resource allocation and funding. Dental Care in Health Reform Current health reform significant focus is on dental care entailing changes in safety net, workforce, infrastructure and payment is likely to impact positively on the School-based sealant program in Massachusetts (MA). The school-based sealant program has been introduced and implemented in line with the evidence based recommendations by the Center for Disease Control and Prevention as an effective measure for the prevention of tooth decay. However, despite the evidence that sealants can be almost 100% effective in preventing tooth decay, only 46% of the 3rd graders in MA have dental sealants (Commonwealth of Massachusetts, 2013). The school-based and school-linked sealant programs are supported by the MA Department of Public Health. However, the program has failed in some areas including the lack of assessment and diagnostic efforts in the implementation of the program as well as inadequate funding from the federal government. However, implementation of the dental care reform in the health reform holds a lot of promise in enhancing the effectiveness of the school-based sealant program among other prevention programs targeted at the school-going children. Increase in federal funding for dental health program is one of the provisions in the reform that is likely to positively impact the number of children benefiting from the sealant program. The grants for the establishment of school-based health centers program which establishes a $50M fund will boost the implementation of the sealant program through the school-based health centers (The Children’s Dental Health Project, 2011). Establishment of the school-based health centers will bridge the assessment, screening and diagnosis of dental problems including decay of teeth among children currently emerging as a limitation in the success of the MA school-based sealant programs. Increased funding will ensure all schools inclusive of private schools adopt or implement the sealant program through establishment of the school based health center. The health reform recognizes that increasing number of school-based health centers (SBHCs) have shown the potential to address the dental health problems through provision of direct dental services (The Children’s Dental Health Project, 2011). These health institutions not only provide direct dental health but also create oral health awareness through provision of dental education. In addition, about a quarter of the already established SBHCs have shown commitment in providing dental examinations, sealants and screening services to school-going children. The health reforms provisions provide an opportunity for the expansion of services provided under the school-based sealant programs to include other important dental care services. The recommended additional financial support of $11B over the period FY2011-2015 meant for expanding community health centers will further complement the efforts by the school-based sealant program in MA through increased access to dental care for the children and the community at large (The Children’s Dental Health Project, 2011). The state cooperative agreements between CDC and the state oral health program will enhance the success of the MA school-based sealant programs via the establishment of oral health leadership and program guidance. Such agreements will boost the expansion of scientific prevention programs recommended by CDC such as water fluoridation and sealants with the MA region. Policy Recommendation School-based sealant programs have proven to be success in preventing teeth decay among children, and so it will be crucial for the federal and the states to increase the funding for such programs. This will ensure that most dental health problems are addressed through the effectiveness of the sealant program. The public health department should draft a policy aimed at consolidating the effort of sealant programs entail a dedicated funding from the federal government as one of the sure ways of preventing tooth decay among the people of MA. In addition, the sealant program should be extended to include families and the larger extent of the community. This would ensure that most people at the risk of preventable dental diseases benefit from the sealant program including women and the aging populations. In order to boost the effectiveness of dental health care promotion programs, dental hygienists should be included as Medicaid providers to benefit from the reimbursement of services. This would motivate dental hygienist to work towards the support of the existing preventive programs as well as coming up with new strategies to ensure effective prevention of dental health problems. In addition, inclusion of dental hygienist as Medicaid providers would facilitate the access to dental health care services among the underserved populations. The public health sector should also be empowered to expand preventive and restorative dental services through funding of research activities carried out in line with discovering more efficient and effective preventive mechanisms. Inclusion of these recommendations into law can be achieved through proper lobbying through the public health ministry and briefing several members of the state legislative. It is important to ensure that the importance and urgency of these recommendations to the improvement of the state’s wellbeing sinks into the minds of the state legislators. This should lead to drafting of a motion capturing these recommendations at both the state and federal levels for adoption. Once the recommendations pass in state legislature, it should be easy for them to pass at the federal level because the state legislature can push their agenda through further lobbying among their colleagues for the recommendations to be adopted or incorporated into the preventive health policies. In conclusion, the health reform under discussion in this paper addresses most issues that must be reviewed to enhance access to dental care as well as dental preventive programs. However, implementation of the suggested recommendations can have a great impact in enhancing effects of the various efforts made towards achieving improved oral health among the people of MA. References Cohen, J. (1999). Presidential responsiveness and public policy-making: The public and the policies that presidents choose. Michigan: University of Michigan Press. Commonwealth of Massachusetts. (2013). Dental sealants. Health and Human Services. Retrieved from http://www.mass.gov/eohhs/gov/departments/dph/programs/community health/oral-health/dental-sealants.html The Children’s Dental Health Project. (2011). A roadmap for implementation, part II: Dental care provisions in health reform. Retrieved from http://www.cdhp.org/system/files/ACA%20Dental%20Care%20Whitepaper%208.1.11. df#page=6&zoom=auto,0,183 Read More