School-based health programs are another option for health centers to consider in expanding off-site direct dental services. School-based health programs provide access to important preventive measures for high risk children such as dental sealants and fluoride treatment. Health centers can follow the checklist below when developing a school-based dental program:

• Build the case and get support for a school-based program as a sustainable service delivery method for expanding oral health services.

• Decide on a delivery model: 1) fixed clinic located in schools, 2) mobile vans parked on school property, 3) portable equipment carried into schools and located in temporary spaces, or 4) multiple models.

• Review your state’s dental practice act to determine supervision guidelines and allowable tasks by dental providers in school-based settings.

• Review state Medicaid guidelines on reimbursement of oral health services delivered in school-based settings.

• Consider the financial sustainability of the school-based dental program. This feasibility calculator can help to assess the financial sustainability of an existing or future school-based oral health program. The HRSA OHI funding can be used to purchase dental equipment and supplies including mobile units and portable dental equipment.

• Establish community partnership, that could include local schools, school districts, and existing school-based oral health programs. The National Maternal Oral Health Resource Center’s resource guide, Promoting Oral Health in Schools lists resources including readiness assessments for oral health programs in schools.

• Determine the services to be delivered within the school-based setting (i.e., preventive, additional, or specialty dental services). NNOHA’s Survey of School-Based Oral Health Programs Operated by Health Centers outlines descriptive findings on school-based health programs’ productivity and services. Additionally, the report provides promising practices and recommendations for funding, consent for treatment, and care coordination. A NNOHA conference session presentation, The Seal is the Deal discusses developing and implementing a school-based sealant program.

• Determine the health IT system for your school-based dental program. Ensure that the system complies with HIPAA standards.

• Establish clinical, referral, and care coordination workflows, new dental team roles, and communication processes between school-based site and health center sites.

• Enroll students and prepare the necessary forms to obtain consent.

• Prepare sites for clinical care through provider and staff training and education.

• Establish an ongoing program evaluation and quality improvement process.

For more information on these steps, access NNOHA’s report and webinar on school-based oral health programs by health centers. The American Dental Association also has a collection of resources for school-based dental programs. NNOHA has a promising practice, Mobile Dental Units for School-Based Dental Care, from a health center that utilizes a mobile dental unit to provide dental care to various school sites in their community.