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Evaluation of Strategies to Recruit Oral Health Care Providers to Underserved Areas in California

The state faces a variety of dental health workforce challenges that limit access to care for underserved populations: low-income individuals, the uninsured, Medi-Cal recipients, racial and ethnic minorities, the elderly, the very young, developmentally disabled persons, and rural residents. While there are numerous factors that contribute to the disparities in oral health status and the problem of access to dental care, a constant and central problem is ensuring that there are providers willing and able to care for these populations. Existing public policies utilize a variety of strategies to address workforce availability in underserved areas, including loan repayment for existing providers to work in underserved communities, training new providers in underserved settings, and recruiting students from underserved backgrounds to enter dental school.

The Center for the Health Professions at UCSF evaluated the historical, current and anticipated policy approaches to recruiting oral health care providers to underserved areas in California. We examined the individual program goals and successes, as well as the combined impact of the programs on increasing access to care in underserved communities.

We examined the following questions:

1. What is known about the level of unmet dental need in California communities?
2. What are the state and private programs in California that impact the number of oral health care providers working in underserved communities?
3. What impact do the programs have in relation to existing need?
4. Do the programs, policies and legislation work in tandem towards addressing the distribution of services?
5. Might existing programs be improved or better articulate with one another?

The project included a comprehensive literature review followed by a search for information on all programs, legislation, policies, and other efforts to increase the number of providers in underserved areas. Following identification of programs to be studied, we collected specific information on each program in order to evaluate the impact of the program's efforts.

This study is the first to provide a comprehensive analysis of the various programs and policies and enables identification of areas of overlap, areas of consistent positive or poor results, and opportunities for further expansion, collaboration and articulation between programs. The results of this study provide valuable information to state legislators, policymakers, dental educators, administrators, program managers, and professional associations.

Publications:
Full Report

Project Staff:
Kevin Grumbach, MD, Principal Investigator
Edward O'Neil, PhD, Co-Investigator
Beth Mertz, MA, Project Director
Gena Anderson, Research Associate

Funding:
California Program on Access to Care, California Policy Research Center (Grant #BNN02K). National Center for Health Workforce Information and Analysis, Bureau of the Health Professions, Health Resources and Services Administration (Grant # 1 U79 HP 00004-010)

For more information please contact Beth Mertz at 415-502-7934 or bmertz@thecenter.ucsf.edu.