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MINUTES - 06081993 - 1.73
s 1 - 73 TO: BOARD OF SUPERVISORS FROM: Mark Finucane, Health Services Director PContra By: Elizabeth A. Spooner, Contracts Administrato Costa DATE: May 27, I.1993 County SUBJECT: Approve Submission of Funding Application #29-250-28 to the State Department of Health Services for continuation of the Dental Disease Prevention Program SPECIFIC REQUEST(S) OR RECOMMENDATION(S) & BACKGROUND AND JUSTIFICATION I. RECOMMENDED ACTION: A. Approve submission of Funding Application #29-250-28 to the State Department of Health Services, in the amount of $121,970, for the period July 1, 1993 through June 30, 1994, for continuation of the Dental Disease Prevention Program. B. Authorize County's Health Services Director, or his designee (Wendel Brunner, M.D. ) to sign the Statement of Compliance and the Drug-Free Workplace Certification forms, on behalf of the County. II. FINANCIAL IMPACT: Approval of this application will result in State funding of $121,970 for the County's Dental Disease Prevention Program for FY 1993-94 . No County match is required. III. REASONS FOR RECOMMENDATIONS/BACKGROUND: This State-mandated program is operated pursuant to Sections 360-373 of the Health and Safety Code. The goal of the Dental Disease Prevention Program is to prevent and control dental disease in children in selected school districts and to provide a comprehensive community-supported and school-based dental disease prevention program. The program serves 25, 000 children in 97 public and private schools in Contra Costa County. In order to meet the deadline for submission, the application has been forwarded to the State, but subject to Board approval. Four certified copies of the Board Order authorizing submission of the application should be returned to the Contracts and Grants Unit for submission to the State Department of Health Services. CONTINUED ON ATTACHMENT: YES SIGNATURE: RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMM ATI N OF BOARD OMMITTEE APPROVE OTHER SIGNATURE(S) ACTION OF BOARD ON 17 7TR 3 APPROVED AS RECOMMENDED OTHER VOTE OF SUPERVISORS UNANIMOUS (ABSENT ) I HEREBY CERTIFY THAT THIS IS A TRUE AYES: NOES: AND CORRECT COPY OF AN ACTION TAKEN ABSENT: ABSTAIN: AND ENTERED ON THE MINUTES OF THE BOARD Contact: Wendel Brunner, M.D. (313-6712) OF SUPERVISORS ON THE DATE SHOWN. CC: Health Services (Contracts) ATTESTED Auditor-Controller (Claims) Phil atchelor, Clerk of the Board of State Department of Health Services $upeIviwr$aAdG=tyAdminist1atX M9e2/7-eeBY DEPUTY 1 - 73 APPLICATION COVER SHEET FY 1993-94 1. Contact person for this Application and Mailing Address 29 - 2 '-- 0 - 28 Agency Name Contra Costa County Department of Health Services Mailing Address 595 Center Ave., #120 City Martinez Zip 94553 County Contra Costa Contact Person's Name Lynn Pilant Phone No. (510) 313-6284 2. Term of Project: From 7/1/93 to 6/30/94 mo./day/year mo./day/year 3. Is your agency currently funded by the California Department of Health Services/Dental Health Section? [X] Yes [ ] No Current Funding Amount $ 100.575 4. Project Title: "Save Our Smiles" Dental Program 5. Number of children to be served: PRE-K K 1 2 3 4 5 6 UNGR TOTAL 2,790 3,400 3,300 3,100 3,500 1 3,100 2,500 2,700 610 25,000 6. Funds requested from State: $112.500 7. The undersigned hereby affirms that the statements contained in this application package are true and complete to the best of the applicant's knowledge, and accepts as a condition of any resulting contract the obligation to comply with applicable state requirements, policies, standards, and regulations. the undersigned recognizes that this is a public document and open to public inspection. Signature t.L,/Date Type Name and Title Assistant Director Health Services-Public Health Division APPLICANT INFORMATION SHEET PLEASE COMPLETE THIS FORM CAREFULLY 1. Agency Information: Legal Name"of Agency : Contra Costa County Department of Health Services Title of Project: "Save Our Smiles" Dental Program Mailing Address: 595 Center Ave., #120 City: Martinez Zip 94553 Federal Tax ID #: 29-250 County (where agency headquarters is located): Contra Costa Telephone Number: (510) 313-6284 FAX Number: (5 10) 313-6115 2. Project Coordinator (This person is responsible for all of the day-to-day activities of project implementation. This person will be the contact person for Dental Health Section staff, will receive all programmatic, budgetary and accounting mail for the project, and will be responsible for the proper dissemination of project information): Name: Lynn Pilant, RDH, BS Address: 595 Center Ave., #310 City: Martinez Zip 94553 Telephone Number: (510) 313-6284 FAX Number: (510) 313-6115 In the event that the Project Coordinator is not yet appointed, identify a contact person for the Dental Health Section to send pertinent contract and program materials in the interim. Name: Address: City: Zip Telephone Number: FAX Number: 3. Financial Officer (This person has signature authority for invoices): Name: Alan Abreu Address: 20 Allen St. City: Martinez, CA Zip 94553 Telephone Number: _(510) 370-5025 FAX Number: (510) 370-5098 4. Agency Official (This person has official signature authority to enter into an agreement for the agency); Name: Wendel Brunner, MD Address: 597 Center Ave.. #200 City: Martinez, CA Zip 94553 Telephone Number: (510) 313-6712 FAX Number: (510) 313-6721 5. All payments for invoices are automatically sent to the address of the Agency Official. If the address of the Agency Official is not the address you wish payments mailed to, please indicate the correct contact person and address below. The Dental Health Section staff will notify the DHS Accounting Section when special handling is required for your agency. Name: Jan Woodward Address: 20 Allen St. City: Martinez, CA Zip 94553 Telephone Number: (510) 370-5031 FAX Number: (510) 313-5098 I certify that the above is true and correct: `1 By (Authorized Signature) Date i ABSTRACT OF PROPOSAL 1. Name of Applicant Organization: Contra Costa County Dept. of Health Services- Public Health 2. Project Title: "Save Our Smiles" Dental Program 3. Project Director: Lynn Pilant, RDH, BS The following proposal is based upon an existing program dealing with children and secondary target populations in the "Save Our Smiles" Dental Program. The project has been ongoing in Contra Costa County since 1977. This project will offer the following components: 1. Weekly fluoride mouthrinsing for children in suboptimally fluoridated areas. 2. Ongoing plaque control program. 3. Dental Health Education Component. 4. Development and linkage to existing community resources to respond to the need for preventive dental health services for children in targeted areas. 5. Parent Education (preschool). The project will provide direct services to 25,000 children for the duration of the project (July 1, 1993-June 30, 1994). This will include special outreach to schools not currently participating in the project that have a high percentage of elementary school children served by the Free School Lunch Program (FSLP). The project will provide education for children, teachers, parents, and other individuals in dental disease etiology and prevention, skill development in plaque control methods and topical fluoride for children in suboptimally fluoridated areas of the county. Development of community resources to address the need for accessible preventive oral health services for preschool, elementary school children and youth with exceptional needs in target high need areas will be established. The impact of the project will be evaluated by pre/post tests, plaque indices and written evaluations. • 1 TABLE OF CONTENTS Project Narrative Description 1 Problem Statement/Needs Assessment 4 Proposed Schools for Project Implementation 6 Scope of Work 12 Evaluation Plan 18 Budget: A. DDPP Line Item Budget 20 B. Budget Summary 21 C. Budget Justification 22 Agency Description and Capability A. Organizational Chart 24 B. Board of Supervisors Resolution 25 C. Statement of Compliance 26 D. Drug Free Workplace Certification 27 E. Resumes for Key Personnel 28 F. Job Descriptions for All Project Staff 30 List of Dental Health Advisory Committee Members 37 Letters of Support 39 Appendices 43 PROJECT NARRATIVE DESCRIPTION The "Save Our Smiles" Dental Program will be a collective effort involving a coordinated program of plaque control, topical fluoride application and educational presentations all aimed at reducing the incidence of dental disease in children. The project will serve 25,000 children grades preschool through sixth grade and special education who are considered at risk for experiencing dental caries and gingivitis based on low-income status and/or living in an area that is suboptimally fluoridated. The program will build on the success of the current program, 1977-present primarily by modifying the goals and objectives to best meet the needs of the target population with the funds available. A secondary target population will include parents, teachers, dental professionals and other adults who interact with children. These groups will be trained in dental disease etiology and methods of prevention, along with the importance of regular checkups, so as to reinforce the components of the program. Special focus will be on children in suboptimally fluoridated areas in the county and those that attend schools with a high percentage of students served by the Free School Lunch Program (FSLP), individuals considered at high risk-for experiencing dental disease. This population was chosen in accordance with the program goals to provide these preventive services to children in high need areas. Prevention efforts need to be focused on children beginning in preschool before caries activity may have begun and while daily plaque removal skills and habits are developing. Instructions on etiology of dental diseases, plaque control, nutrition, fluoride, sealants, dental injury prevention and the need for regular dental care needs to be initiated during elementary school as well. The project will include the following components: (1) direct dental health education for children in targeted schools; (2) fluoride mouthrinse component for children living in suboptimally fluoridated areas; (3) training and/or updates for participating teachers and other adult support staff; (4) parent education; (5) optional dental screenings in selected schools for data collection and evaluation purposes. These activities were chosen as outlined in the mandated activities and our 15 years experience with this program, which demonstrate that a comprehensive school based program aimed at reducing the incidence of dental caries and gingivitis must include a multifaceted approach. Teachers, parents and other members of the community with direct roles of education and daily supervision of these children must be included to support the effort to create daily habits and knowledge, helping these young people develop proper skills and make healthy choices regarding their oral . health. Repetition of activities with specific feed back, incentives, study of consequences, adult supervision and support have all been demonstrated to be key ingredients in a successful dental health program. 1 Major components of the Program: 1. Direct dental health education and plague control for children in targeted schools. Presentations 30-40 minutes in length will be geared toward appropriate grade level and made as interesting and engaging as possible. Posters, display models and interactive games will be used. Information on dental disease etiology and prevention will be shared through these activities. The children will be given verbal as well as visual demonstration on effective plaque control techniques with specific feedback on their skill development. Kindergarten-6th grade children in the target group will be provided the opportunity to participate in a daily plaque control program. Teachers will be given the opportunity to choose from the following. a. Daily classroom brushing throughout the school year. Students will receive educational presentations from dental program staff and will be given specific feedback on skill development. Daily flossing throughout the year will be available by request b. Daily classroom brushing and flossing for 25 consecutive school days (flossing for K-3rd grade optional). Students will receive educational presentations from dental program staff and will be given specific feedback on skill development. Following the classroom plaque control program, students will take their dental supplies home to begin a self monitoring daily program. They will maintain a daily record that will be initiated by their parent or guardian and returned to the child's teacher monthly. At the completion of the school year, the forms will be collected by the dental program staff. 2. Fluoride mouthrinse component for children living in suboptimally fluoridated areas . Participants living in these targeted areas will with parental consent, have the opportunity to rinse with a 0.2% weekly fluoride mouthrinse for a minimum of 30 weeks. Children will also receive training on "how to" do this weekly rinse by dental program staff. Teachers monitoring this activity will also receive training prior to initiation of this program component. 3. Training and/or updates for teachers and other adult support staff. Head Start and State Preschool staff will attend an annual training regarding the dental program. Elementary school teachers and support staff who are new to the program will receive an initial 1 hour training session with an annual 15-30 minute "update" in following years. Teachers who are continuing with the program will be required to attend only a 15-30 minute "update" each year. The purpose of these workshops is to assure that the teachers are adequately prepared to monitor the program activities in their classrooms. 2 4. Parent Education . This part of the program will be offered to all parents of Head Start and State Preschool children. Special incentives, (toothbrush kits, etc) will be offered as a method of increasing attendance at the workshops. Topics may include dental disease, etiology and prevention, importance of assisting preschoolers with daily plaque removal coupled with demonstrations on how to accomplish this. The importance of good nutrition for dental health and the benefits of preventive agents such as fluorides and sealants may also be discussed. 5. Optional dental screenings in selected schools for data collection and evaluation purposes. A sample of 5% of participating children will be screened to determine effectiveness of various plaque removal strategies. • The services described in this narrative will be provided by the supervising dental hygienist, senior public health dental assistant and 3.0 FTE student outreach workers. They will be supported directly by administrative and clerical staff from Contra Costa County Maternal, Child & Adolescent Health Unit. In kind support will also be provided by volunteers from the Contra Costa Dental Society (Tooth Tutors); their efforts reach over 5,000 children each year. The Dental Society also provides printing services and materials for the Tooth Tutor Program. Students, teachers and parents have shown great interest in our presentations. Their comments and suggestions have been taken into account in the development of this proposal. There are several barriers that may be encountered in the implementation of the program. They are listed as followed with methods of overcoming them. Barriers Method of Overcoming 1. Teacher's days are already full of 1. Teachers are prepared at a training mandated activities, difficult to workshop with suggestions on how conduct daily plaque removal. to carry out the program activities with a small investment in time. 2. Low program reimbursement 2. Continue to solicit donations from makes purchasing good quality service organizations, merchants supplies difficult. and local dental society. 3. Poor attendance by parents at 3. Provide incentives to encourage preschool workshops. attendance. The Save our Smiles Dental Program, sponsored by Contra Costa Health Services has maintained long standing mutually beneficial relationships with several local organizations and programs including the Department of Education, Contra Costa Dental Society, California Children Services, WIC, Child Health and Disability Prevention program and the TeenAge Program. Integration with these groups has enabled our program to provide a wide variety of innovative services to our target population for the past 15 years. 3 PROBLEM STATEMENT/NEEDS ASSESSMENT 1. Demographic Information Residents of Contra Costa County represent a very diverse cultural and socio-economic population. (See Appendix A). Of 776,000 people, 148,064 are elementary school children Kindergarten through sixth grade, including children with exceptional needs (Dept of Finance 1989). It is estimated through Free School Lunch Program (FLSP) statistics that 24% of these kids are in the target high risk population (@35,535). These figures do not include preschool children. However during the 1991-92 school year 3,600 children in Head Start, State Preschools and Child Development centers participated in "Save Our Smiles." According to CHDP health check-up records (PM-160's) dental disease continues to be the #1 problem identified. Of the referrals made to the Contra Costa Co. 200% Program over 90% of them are for dental care. There exists a large amount of untreated dental disease in our children. 1989 Contra Costa Denti-Cal utilization rates show that only 16.8% of children (0-21) eligible for dental services receive care. This represents a utilization rate of 10% below the state average(17.8%) which demonstrates the high need for dental care and preventive services. 2. Available Prevention Oral Health Services Referral for dental services are provided to children in the target population through an integrated approach of public and private agencies. a. The largest impact is made through the SB-111. Dental Program, serving over 25,000 children annually with a comprehensive school based program. The local Dept. of Health Services provides additional funding to SB-111. Also the Contra Costa Dental Society provides volunteers, supplies and printing services. Strengths Weaknesses • Serves large # target • Not enough funding children from state • Has additional finan- • Limited # of chil-dren cial support served • Strong liaison with other agencies b. Baby Bottle Tooth Decay (BBTD) prevention education is provided by SB-111 staff to clients of the WIC program each summer. The greatest impact on the target population is for those children who advance from WIC to Head Start or State Preschools. It is our hope that they will not be entering preschool with BBTD. A community coalition, C.U.P.S, has formed and is targeting BBTD prevention as its primary objective. Strengths Weaknesses • Reaches target popu- • Limited funding--not lation before disease able to provide year process begins round • No duplication of services • Saves treatment $ • Utilizes dental pro- fessionals to provide education 4 Problem Statement/Needs Assessment Page 2 C. Dental Sealant Clinics-serving (&150 children each year are held through a combined effort between SB-111,CHDP,Diablo Valley College Dental Hygiene Program, Contra Costa Dental Society and Richmond Rotary Club. This program reaches children in Head Start and Child Development Centers "After School Program" children. A task force "Expanded Care Committee" has been formed to expand this program throughout the county. Strengths Weaknesses • Overwhelming com- • Not enough re-sources munity support to reach a significant • Excellent use of number of target resources children d. In Contra Costa County, CHDP has initiated 2 important dental programs to improve access to treatment and preventive services for children. 1. "Help the Children" links DentiCal eligibles to necessary services. 2. "200% Program" linking low income children to care with Tobacco Tax revenues. Children are often identified for these programs through SB-I I I Dental Screenings. Strengths Weaknesses • A step t o w a r d • Not enough pro-viders, improving access to especially pediatric care dentists • Uses existing re-sources • Networking of or- ganizations 3. Analysis of Comprehensiveness vs Existing Resources Despite the programs available, large gaps in access to preventive oral health services exist for children in Contra Costa County. First, there are over 18,841 children K-6th grade served by the FSLP in Contra Costa County. It is requested in this proposal to serve 25,000 children, at least 50% of which are served by the FSLP. At best, serving 12,500 children at risk, there will obviously still be a great many target children who will not receive the opportunity to participate. The BBTD Program, although benefits children in our target group, is not directly included in the SB- I I I program. There are many children who experience dental caries before entering preschool--costing thousands of dollars in restorative work, along with the pain and suffering for the child. Dental Sealant clinics have been very successful in reaching several hundred children with this very important preventive service. Unfortunately with limited resources thousands of other children who would benefit from sealant application are not able to receive them. "Help the Children" and the "200% Dental Program" have helped to improve access to dental services for some children. 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O 3 3 3 3 3 3 c n o n n c ° z o O 0 m 0 O 0 CO f7 0 0 O O O O O O O O O N ° m 0 0 0 0 0 0 0 o a o a o o a o w s a -" a R - a r T CD C. m O. an d m a d d 7 7" m 7" m 7" 7 m m. m m _ 3 �' 3 �' 3 �' 3 > >' :' m m o m o m m o m 7 0 Cr m m m m m m m O O o 0 O o y 0 y 0 y 0 y 0 O O N m O Z o 0 m T 3 D O v 0' 70 3 D m y < m m c 0 S 0 0 �+ O m c m m c c c com Q o m cam c C) ° ID m m m m m a m m m 0 a 3' C m D o T O m 7 0 M m j Z O m (n 7 3 3 N o' D o m S O m 2. m m m S C 1 CD m N .7-. m N » » m m m O m y 3 m a 3 m y m Z a m y a m N 3 m 3 Q m m 3 Om y y D' m m y m y y 7 m y 7 m N FL m y O S O O 16 $ � � ® o % $ # & ¥ % \& k % o $ . M T s , ¥ , o a \\\ \ » 0 , 6 � � ƒ ¥ » � ao " « \ a § + $ a % ° s ° � © � CD ® � � 5 �.■ � . « > $ § t . � o & m = o : ƒ e % Ie % � e � � \$ k $ ° 2\ & $ \\ \ i0 / 500 \a ° \ ts ® ° k 0 # r . # � k � � . � EVALUATION PLAN 1.1 Fluoride mouthrinsing in suboptimally fluoridated areas. Fluoride mouthrinsing will be conducted in schools located in suboptimally fluoridated areas. Participating children will be identified by teacher sign-up forms; those children who have parental permission will be logged on classroom fluoride grids. Documentation showing the total number of weeks each child rinsed will be shown on classroom fluoride grid maintained by the teacher. Mid-year and year-end teacher evaluations will be used to assess teacher compliance with weekly mouthrinsing; this information will be included in the quarterly and/or annual report. 1.2 Preschool Fluoride Toothpaste Brushing_Proogram Daily brushing with fluoride dentifrice will be conducted in State Preschools and Head Start Programs. Participating centers will be identified by teacher sign-up. Those children with parental permission will be logged on a daily brushing chart to be maintained by the teacher; documentation of the total number of days each child brushed will be recorded on a Daily Brushing Chart. Teacher evaluations will be used to show compliance with this activity. Summary will be included in quarterly and/or annual report. 1.3 Teacher Training All teachers new to the program will attend a 45 to 60 minute training workshop. Attendance will be recorded and monitored by signed attendance sheets. A pre-post test will be administered to a sample 10% of all new teachers to determine effectiveness of workshop. Evaluations will be given to all teachers. Summary will be included in quarterly and/or annual report. 1.4 Pre-Post Gingival Index 1.5 1.6 A pre-post OHI-S index will be obtained from a sample 5% of participating children to determine effectiveness of classroom vs. home plaque control activities. Screenings will be conducted by volunteer dentists. Results will be summarized in quarterly and/or annual report. 2.1 Oral Health Education - Preschool Total number of parents and teachers attending workshops will be documented by signed attendance sheets in school file. Records of teachers utilizing dental health curriculum 18 Evaluation Plan Page 2 will be noted on school rosters in file. Teachers will report on effectiveness of materials on evaluation forms. Summary will be included in quarterly and/or annual reports. 2.2 Oral Health Education - Elementary 2.3 To evaluate effectiveness of classroom presentations pre-post test will be administered to a 5% sample of participating children from all grade levels. Education games are also used during classroom visits to provide specific feedback. Results will be tallied and summarized on quarterly and/or annual reports. 3.1 Dental Health (MCAH) Advisory Board Progress on development of strategies to meet the dental needs of children and families at risk will be followed through minutes from Advisory Board meetings. They will be studied and evaluated to determine if all points in stated objective are accomplished. Minutes will be included in quarterly and/or annual reports. 3.2 Dental Health Advisory Board Membership Roster of current membership including names, addresses, phone numbers and agency represented will be maintained to assure proper representation from; the dental profession, education and parent groups. Recruitment of new members will be done as needed. 3.4 Public Education Strategy A roster of participants will be maintained as documented by attendance sheets at each meeting. Progress on completion of stated objectives will -be .noted in minutes and summarized in quarterly reports. 19 DDPP Line Item Budget Contractor: A. Personal Services (including position Proposed State & rate x time calculations) Funding $ amount 1. Health Program Specialist I ($4, 351-$4, 620/mo. x 1. 0 FTE x 12 mos. ) $40, 699 2. Public Health Dental Assistant ($1,750-$2, 540/mo. x .8 FTE x 12 mos. ) $17, 771 3 . Dental Health Facilitator ($7.31-$8 . 50/hr x 3 , 500 hrs. ) $18,929 SUBTOTAL SALARIES: $77,399 B. Fringe Benefits @ Actual $19, 534 SUBTOTAL PERSONAL SERVICES: $96,933 C. INDIRECT COSTS (@ 10% of Personal Services) $9, 693 D. General Expense $2 , 589 E. Expendable Supplies $5, 356 F. Printing & Duplicating G. Communications & Postage H. Travel, Per 'Diem & Training $2,220 I. Contractual Services J. Educational Materials K. Rent & Utilities $5, 119 L. Other (Specify) SUBTOTAL OPERATING EXPENSES (D-L) $15,344 TOTAL $121,970 20 C`Z d 0.3, CD � � n cr- vool R° Qo �, �d � d v` tp k-n Al), `G No •+ O d O S n t o c� 0 21 cr CONTRA COSTA COUNTY "Save Our Smiles" DENTAL DISEASE PREVENTION PROGRAM BUDGET JUSTIFICATION July 1, 1993 THROUGH June 30, 1994 A. PERSONNEL EXPENSES: Reasonable prevailing rates based on Contra Costa County having one of the highest cost of living rates in the U.S. Public Health Program Specialist I Project Coordinator $55,011 $4351-4620 per month X 100 percent X 12 months Position will serve as overall Project Director. Responsibilities include overall planning, supervision, development, training, report writing, and general coordination of project. Senior Public Health Dental Assistant $24,020 $1750-2540 per month X 80 percent X 12 months Position serves as the assistant to the Project Coordinator. Under supervision provides training and supervision to student workers, recruitment of schools, assists with curriculum development, conducts classroom presentations and performs related work as required. Student Dental Health Facilitators $25,585 $7.31-$8.50 per hour 3,500 hours Position serves as primary educators for the project. Besides classroom presentations, duties include organization of mailings to schools. Assist with scheduling, delivery of supplies, inventory, record keeping, and assist with development of educational media. Fringe Benefits: a. $23,709 b. $2,694 a. Permanent Employees: The 30% rate utilized for fringe benefits is based on Contra Costa County permanent employees schedule of fringe benefits: Benefit Benefit Total Amount Percentage Percentage FICA 328.30 7.55% RETIREMENT 631.56 14.52% MED INS 204.01 4.69% OTHER 28.72 .66% WORKERS COMP 113.13 2.60% SUI 12.18 .28% 30.29% SALARY 4,351.00 100.00% , b. Temporary Employees: The 10.53% rate utilized is based on Temporary Employees only receive FICA, Workers Comp a rate of 10.53% (FICA rate is 7.65%) TOTAL PERSONNEL EXPENSES: 131,019 22 Contra Costa County "Save our Smiles" Dental Program Budget Justification Page 2 B. INDIRECT EXPENSES: $12,620 The 10% indirect expenses include administrative expenses (Public Health Director, Account Clerk, and payroll expenses), utilities, building and equipment maintenance, janitorial services and insurance expenses. C. OPERATING EXPENSES: General Expenses: $3,500 Includes all general office supplies; expenses for postage expenses for project mailings and general correspondence and materials; expenses for internal, routine duplicating expenses for project correspondence and materials, expenses for outside vendor printing and reproduction, e.g., brochures, leaflets, forms, posters, etc.; the purchase of educational materials, pamphlets, posters, curricula, videos,. etc. Expendable Supplies: $7,240 Includes purchase of toothbrushes, covers, dental floss, floss holders and fluoride mouthrinse supplies for 25,000 participating children. Space Rent/Lease: $7,000 Includes rental cost for 4.0 FTE project staff. Rate based on .7% of cost of building. Travel: $3,000 Includes travel and per diem expenses in accordance with current State DPA rates, approximately 1,740 (604 miles/mo. X 12 mos. @ .24/mi = $1,740), plus travel and per diem expense for one staff member to attend required regional and statewide training meetings. (260 X 1 FTE staff per year = 260) TOTAL OPERATING EXPENSE: $164,861 23 G § / | i f |§ CD C) 0 ¥ � � §||| n ;e■e|!||"|! | | � .: | �■ ,.,� | ® § = !■■ � ■ C-) � ����/§��(��k���� � k � ! ■ |� � � 7C) C ci F— 0 ||8§R|||e| |®2222© ■ § 2 'a| ; § §| f | § ■ •� § k . � � | �§ mz|m`®!| ps �|2 §|q ;z, 77( { a || k ■ - | | |� D . a � � ■�l ,R„�„! B � � � k }k K 2 } k . � 2 � . � §m ■:■ §\| 2|||§f|§2||||2n FTI| , ■- &| .; -@ § A � - ■|�§ k § � §�§|k!:|■ � 7 � � \ B ) � 24 AUTHORIZATION OF GOVERNING BODY A request for a Contra Costa County Board of Supervisors Resolution authorizing this application and establishment of authority to negotiate a contract with the Department and to execute amendments during the contract year, is in process. The Boards Resolution will be forwarded as soon as obtained. The request includes delegation to Wendel Brunner, M.D., Assistant Director, Health Services Department, authority for certifications as required. 25 STATEMENT OF COMPLIANCE Contra Costa County Department of Health Services The company named above (hereinafter referred to as "prospective contractor") hereby certifies, unless specifically exempted, compliance with Government Code Section 12990 and California Administrative Code Title, Division 4 , Chapter 5 in matters relating to the development, implementation and maintenance of a nondiscrimination program. Prospective contractor agrees not to unlawfully discriminate against any employee or applicant for employment because of race, religion, color, national origin, ancestry, physical handicap or medical condition (cancer related) , marital status, sex or age (over forty) . CERTIFICATION I, the official named below, hereby swear that I am duly authorized to legally bind the prospective contractor to the above described certification. I am fully aware that this certification, executed on the date . and in the county below, is made under penalty of perjury under the laws of the State of California. Wendel Brunner, M.D. Name of official j -- Contra Costa Date Executed Executed in the county of Prospective Contractor Signature Assistant Director of Health Services, Public Health Division Prospective Contractor Title Prospective Contractor Federal Employer I.D. Number 26 DRUG-FREE WORKPLACE CERTIFICATION COMPANY/ORGANIZATION NAME Contra Costa County Department of Health Services The contractor or grant recipient named above hereby certifies compliance with Government Code Section 8355 in matters relating to providing a drug-free workplace. The above named contractor will: 1. Publish a statement notifying employees that unlawful manufacture, distribution, dispensation, possession, or use of a controlled substance is prohibited and specifying actions to be taken against employees for violations, as required by Government Code Section 8355(a). 2. Establish a Drug-Free Awareness Program as required by Government Code Section 8355(b), to inform employees about all of the following: (a) The dangers of drug abuse in the workplace, (b) The person's or organization's policy of maintaining a drug-free workplace, (c) Any available counseling, rehabilitation and employee assistance programs, and (d) Penalties that may be imposed upon employees for drug abuse violations. 3. Provide as required by Government Code Section 8355(c) that every employee who works on the proposed contract or grant: (a) Will receive a copy of the company's drug-free policy statement, and (b) Will agree to abide by the terms of the company's statement as a condition of employment on the contract or grant. CERTIFICATION I, the official named below, hereby swear that I am duly authorized legally to bind the contractor or grant recipient to the above described certification. I' am fully aware that this certification, executed on the date and in the county below, is made under penalty of perjury under the laws of the State of California. Wendel Brunner, M.D. Officials Name Contra Costa Date Executed Executed in the County of: Contractor or Grant Recipient Signature Assistant Director of Health Service, Public Health Division Title Federal ID Number 27 LINDA PILANT 2290 Holbrook Drive Concord, CA 94519 (510) 798 - 7240 (H) (510) 313 - 6280 (W) COLLEGE EDUCATION AND DEGREES: 1974 - 1975 Platte Technical Community College 1975 - 1978 University of Nebraska - Bachelor of Science; Certificate in Dental Hygiene PROFESSIONAL LICENSES: 1978 National Board Certificate Nebraska Dental Hygiene License #464 California Dental Hygiene License #8461 EMPLOYMENT EXPERIENCE: JULY 1986 TO PRESENT: Public Health Program Specialist Contra Costa County Health Services 595 Center Avenue, Suite 310 . Martinez, CA 94553 DUTIES• Plan, coordinate and supervise the activities of the SB 111 dental program within the Public Health Division of the Health Services Department. Prepare program proposal for grant applications, prepare annual and quarterly report, implements State and Federal program guidelines, assess need for program, recruit, train and hire staff, develop and review educational materials, conduct program evaluation. JANUARY 1979 TO AUGUST 1988 : Clinical Dental Hygienist Supervisor: GAIL E PARRY, DDS DUTIES: Clinical, prophylaxis, x-rays, curettage, impressions, polishing amalgams, patient education in preventive oral hygiene. FEBRUARY 1979 TO JULY 1986: Public Health Dental Hygienist Contra Costa County , DUTIES• Assist in planning, implementation and evaluation of Dental Disease Prevention Program. Conduct classroom education, provide teacher inservice training, develop curriculum and educational materials, supervise activities of Dental Health Facilitator, record data, serve on Advisory Boards (MCAH and Head Start) . PROFESSIONAL ASSOCIATIONS: 1978 to PRESENT Member, American Dental Hygiene Association 1985 and 1988 Delegate, Mt. Diablo Dental Hygiene Component 1983 to 1988 Member, Public Relations Committee Mt. Diablo Dental Hygiene Component REFERENCES: References will be furnished upon request. 28 1 Peggy LeDoux 567 Oakland Ave #310 Oakland, CA 94611 (510) 313-6281 (W) (510) 547-0861 (H) EXPERIENCE: 8/76 to Present Public Health Dental Assistant Contra Costa County Health Services 595 Center Avenue, Suite 310 Martinez , CA 94553 (5 10) 313-6281 Supervisor: Lynn Pilant (510) 313-6284 Prepare and conduct classroom education on the principles of dental disease prevention in Western, Central and Eastern Contra Costa County for children and adults. Conduct teachers and parents inservice. 2/76 to 7/76 Mental Health Clinical Assistant Contra Costa County Mental Health 100-38th Street Richmond, CA 94508 Supervisor: Helen Neilson Act as liaison between therapist and mentally or emotionally disturbed patients. 1/64 to 1/76 Licensed Vocational Nurse Saint Mary's Hospital 450 Stanyan San Francisco, CA (415) 668-1000 Supervisor: Helen .Skerl Provided acute patient care in all hospital wards. EDUCATION: High School Diploma, Lincoln High School, Milwaukee, Wisconsin Milwaukee Vocational School Milwaukee, Wisconsin REFERENCES: Available upon request 29 Contra Costa County April 1988 Revised: April 1993 PUBLIC HEALTH PROGRAM SPECIALIST I DEFINITION: Under general direction plans, coordinates and supervises the activities of a specially funded health education or health care program within the Public Health Division of the Health Services Department; provides public health information and educational services to the public; and performs related work as required. DISTINGUISHING CHARACTERISTICS• A Public Health Program Specialist I is responsible for conducting a county-wide health education or health service program in areas such as dental disease prevention, immunization assistance, adolescent health education, sexually transmitted diseases acquired Immune Deficiency Syndrome (AIDS), Child Health and Disability Prevention (CHDP), Early Periodic Screening Detection and Treatment (EPSDT) or Communicable Disease Control. Public Health Program Specialist I is distinguished from Public Health Program Specialist II in that the latter class is responsible for the administration of a larger and more diversified health care program. TYPICAL TASKS: Prepares program proposals for grant applications; prepares annual and quarterly reports; sets goals and objectives and establishes program priorities; implements state and federal program guidelines; meets with community organizations to promote program goals conducts educational outreach activities and develops program information material for distribution to schools, organizations, community groups and the general public; conducts inservice education and orientation for program staff; attends meetings and seminars and participates on various committees; coordinates the scheduling of health clinics with County Staff; assesses needs for health care programs in schools and meets with school administrators to develop health programs to meet state mandates; coordinates clinical and health education programs for teenagers; provides information and technical assistance to public and private schools relative to state immunization requirements; develops and distributes immunization awareness information and packets for school personnel and parents; reviews immunization records of school age children; manages Sexually Transmitted Disease (STD) clinic activities; plans and develops STD service availability and field investigation; represents STD program at meetings with the State; communicates program plans and needs to STD controller for administrative review and program planning; plans, implements and coordinates county-wide dental disease prevention program; assists in managing day-to-day affairs of the Child Health and Disability Prevention (CHDP) 30 Public Health Program Specialist Page 2 Program and the Early Periodic Screening Detection and Treatment (EPSDT)Program; performs certain program coordination, program liaison, and case management activities in the CHDP/EPSDT programs with a focus on professional nursing considerations; assist in developing policies for combating the AIDS epidemic; performs program development and program implementation work in the AIDS Program; develop and implement protocols for disease investigation, testing and services delivery; recruit services delivery contractors, monitor contracts; staffs departmental AIDS committee to help better coordinate services activities; represents the department at meetings with state and federal program representatives, community agencies and the general public; orients, trains, supervises and evaluates the work of subordinate staff. MINIMUM QUALIFICATIONS: Education: Possession of a Baccalaureate Degree from an accredited or university with a major in nursing, health education or a closely related health care field. Experience: Two years of experience, or its equivalent, in a public health facility providing direct health care services to patients or performing administrative duties in a health care organization or program. Substitution: Possession ofa Master's Degree in any of the aforementioned fields or a closely related major may be substituted for one year of the required experience. One additional year of experience of the type noted above can be substituted for the required academic major. No substitution is permitted for a Baccalaureate Degree. QUALIFICATIONS FOR RESTRICTED POSITIONS: Sexually Transmitted Disease (STD) Program: Education: Possession of certificates of completion for two of three courses in venereal disease epidemiology from the center for disease control. Experience: Two years of full-time experience, or its equivalent, in a public health sexually transmitted disease program performing field investigation and clinic management activities. 31 Public Health Program Specialist I Page 3 Dental Disease Prevention Program: Education: Possession. of a valid license as a Dental Hygienist issued by the State of California Board of Dental Examiners. Child Health and Disability Prevention Programs- Education: ro ram:Education: Possession of a valid certificate as a Public Health Nurse issued by the State of California. Communicable Disease Control: Education: Possession of a valid certificate as a Public Health Nurse issued by the State of California. KNOWLEDGE, SKILLS AND ABILITIES: Knowledge of administrative principles applicable to the organization and functions of health education and health care programs; knowledge of the general principles of communicable disease control; knowledge of the principles of work organization; knowledge of the basic elements of supervision; working knowledge of medical terminology; working knowledge of the organization, functions and inter-relationships of various medical care services and facilities such as hospitals, nursing homes, clinics and voluntary agencies; ability to supervise and coordinate the work of others; ability to compile and analyze data; ability to organize material and write clear and concise reports; ability to conduct training and health education programs; ability to mobilize community support to combat emerging public health problems; ability to speak clearly and effectively to the public; ability to arrange and conduct public meetings; ability to work harmoniously and effectively with federal, state and county staff, school administrators, nursing home directors, private physicians, vendors, health care providers, community agencies and the general public. Class code: VBSD 32 Contra Costa County April 1988 Revised: April 1993 SENIOR PUBLIC HEALTH DENTAL ASSISTANT DEFINITION: Under general supervision, provides training and supervision to student workers and volunteers in the dental health programs; develops and implements the dental health recruitment plan for schools, volunteers and student workers; assists with curriculum development; conducts educational programs to promote good dental health; performs related work as required. DISTINGUISHING CHARACTERISTICS: Senior Public Health Dental Assistant is located in the Public Health Dental Disease Prevention Program and is responsible for promoting an understanding, appreciation and practice of good dental health habits for children, adolescents, parents and professionals through educational programs on dental disease prevention, nutrition education, dental consumerism and dental safety. This class is distinguished from Public Health Dental Assistant in that the latter is responsible for conducting classroom education on good dental health practices while this class is primarily responsible for the training and supervision of student workers and volunteers in the dental program and for organizing and coordinating program activities in elementary and special education school. It is further distinguished from-Public Health Dental Hygienist in that the latter is licensed to conduct dental screening activities and may refer children for dental care treatment. Supervision is provided by a Public Health Program Specialist I. TYPICAL TASKS: Trains and supervises student workers and volunteers who conduct classroom education on dental health; recruits and makes presentations to schools, colleges and local dentists and dental hygienists on the dental program; schedules and coordinates dates for school presentations for program staff and curriculum; develops visual aids; assists in the development of training modules for dental health facilitators; conducts classroom education on the principles of dental disease prevention; assists children in proper tooth brushing, dental flossing and mouth rinsing as part of the dental health education program; conducts inservice training for teachers who participate in the dental programs; attends programs such as Back-to-School-Night to familiarize parents with the dental health program and good dental care practices; monitors the delivery of supplies to school sites; records data on the dental health status of children and adolescents during dental screenings; assists with the interviewing and evaluation of student workers; prepares and maintains records and reports on the dental program; attends staff meetings. 33 SENIOR PUBLIC HEALTH DENTAL ASSISTANT Page 2 MINIMUM QUALIFICATIONS: License Required: Valid California Motor Vehicle Operator's License. Education: Successful completion of a Dental Assistant curriculum from an accredited Dental Dental Assistant Program. Experience: Two years of fulltime experience or its equivalent in the presentation of community dental health educational programs. Substitution for Education: Either one year of full time experience or its equivalent as a Dental Assistant or in the presentation of community dental health educational programs may be substituted for the required education. Knowledge, Skill and Ability: Knowledge of dental hygiene which includes proper tooth brushing and flossing techniques; knowledge of health education principles and practices; knowledge of contemporary dental terminology, particularly as it relates to Public Health dental programs; ability to give individual an group instruction in dental hygiene; ability to keep records and to prepare clear and concise reports; ability to illustrate presentations with appropriate educational materials; ability to conduct dental health education presentations; ability to communicate with community groups and motivate. them in the prevention of dental disease; ability to direct the work of others; ability to work effectively with program staff, volunteers, teachers and parents. Class Code: VMVB 34 Contra Costa County STUDENT DENTAL HEALTH FACILITATOR I. Preliminary Training Before performing the duties of a Dental Health Facilitator, it is necessary for the quality of the Dental Program that each facilitator: 1. Attend staff meetings that will be held periodically throughout the year. 2. Observe trained dental staff giving dental health presentations to children, teachers, parents and other participating groups. 3. Give several dental health presentations under the supervision of trained dental staff. It is left to the discretion of the area supervisor when the facilitator is ready to work independantly. 4. Understand and abide by the rules of the office concerning accountability of time which are: a. report to school location for scheduled activity at the time prearranged. b. if no community activity is scheduled, report to the dental office during the hours the facilitator has stated they will work with the dental program. C. call the dental office and the school to report if they will not be able to work so that a substitute or a rescheduling can be arranged. d. each day on the signout board in the dental office indicate the location where they will be working and the time they will return. e. sign out on board with a return day and time and call if there is a change. f. submit time card to Program Coordinator for signature by the 15th and the last day of the month. 35 STUDENT HEALTH FACILITATOR Page 2 II. Duties of the Dental Health Facilitator Following adequate training, the dental health facilitator will: A. Work with Schools: Under the direction of the Program Coordinator, assist with: 1. Teacher's meetings at their assigned schools, to explain role function in that school. 2. Schedule and conduct initial and follow-up dental health education sessions: a. coordinating availability of other dental staff members to assist with education. b. assist teachers with requesting follow-up education and fitting dental curriculum into existing curriculum. 3. Assuring that teachers have all the necessary supplies. a. toothbrushes, etc. b. assure availability of fluoride mouthrinse supplies where needed. C. assist teachers with various aspects of the dental program (i.e. toothbrush storage, record keeping, efficiency, etc.) 4. Consulting with teachers, parents, children and school administrators regarding any on-site problems and work to resolve these problems. 5. Scheduling parent education programs. 6. Recording and collecting findings during dental screenings. B. Develop educational Media Construct posters, flip charts and other appropriate media to supplement education sessions. 36 �D co J a\ Ln A w N F LI v 07 3 n -- w -• CO cn 0 a a a 0 (D roC ca nrr a < K K IN O F✓ (D N r- r- ? (D r- tJ w K K I-+ O a O rt a < >�. a G. r• K (D O O (D ::r r- (D En K (D rt (D K O 1 K rt LI a '•< N C a (D n t~ "b (D O -0 r• H. ? O C < N LI 3 O+ O PC 0 3 a (D K (D O r- O En a r- £ N a (D O K (D (D (n 3 N r-rt cn v -- K O r• rt Q rt (D O fn O 0 O rt C K a (D r- cn (D r- rp ID rt a rn 0 a K K (D l< 3 rt v a K Ch z £ Nn n w n1-' 3w co xN roN :c W ;UaN v a %�o 0 O co O N O J (D A (D 00 H. to a w w r �C N UI v 7 N :s O 0 m [*] O o cn m O In C �• ? o� 3 c O 0 11 r n r• r F-' G 3 IJ' n rt W K w K n a (D 0 0 C O (D E ct PCO "ar1i x C d (D G. 7 K < (n % K rr C n In (D (D C rt (D rt r• n a K x C1 W n £ O C O > 04 K K - x t" C (Dr nC• nC > 0 Crt bM, (D � H (D K > £ > r O K rt rt (D r• n > > x x O K a '-< O x > < H z O (D n U1 ko > a (D v > a �c Av > > A < : n < A b. 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(D (DD "L7 r• 3 • � v a N F✓ � K F✓ � r r r � 0 0 o cD o 0 0 0 0 0 I I I (n 1 I I 1 1 I �D %D %D �o t0 w lD �D In w W w W Ln A W A 37 C3CE to r r r r r r r r r . a 6< co J D\ Ln A W N r O r'f N 7 > H > 0 6< r a ~+] to r• m 'TJ 'rJ >y < < < < < < G 7y a ro hn m r •• r a Iv c+ w w a m CD z r O > Iv 0 n 0 n n n < Ai �+ � n = tm b = a a a a a a o r 8 AI Iv O n :3 O O :1 m 07 fi rt ft rt rt rt r-4 rt < rt N 7 C G rt n 3 0 n r (D x D) CD sv n f.. 1..1 o UI Fx+- U 1 13) w ro C m 2 03 a ° ►�_ (D K K v 0 r c1i 0 n ttj z H x nN ror rota t2i Gn Gn In Ln O GTI F•- 1D rrrr :5 o fro rtr t" 0 0 0 0 0 O rt N rt H vvvv 0 UI U1 (n x W W W W a S G H G O W W W W 4 (D UZ (D C I 1 1 1 o ft :c H O NNrJ � (n n0 n0 O coLTIa% r Ort > a > :0 A a% r N A 1-( a fG N (D GD tv O rt A a A O Gn C1 GTI b a% (D CIN v, cn v x z Gn Ln Ln Gn to WWW %D E 2 w Ln J Ln J -- v nnnn tT A A ty mmmm J N to 1"4 O\ J co O ftrtrtrt, I I I H (D m m m N O ri pi pi ri Gn o ,a v ryb > > c o (D mm (D L' n r W WN > > 3 3 (nn W no En 3 H (7 H N m r 0 N r m (D m O N O n G rn (D O 1— C Ln O O (n tv 5 0 ( 9 ts 0) 'L7 1 A 29 (n O Q V < 5 a r n rt r- tl• rt w 0 m (D m G w? 0 m H pi ► -a K n 0 0 a rt F'- m n O r- 3 3 3 3 A+ (D w N- Ir- O ri 0 tvwaw rt W a r) rt N Oa rnO sv rft n n n " W n ft rr rr O n rn rt 21 rt, rtrtrt O n v K m to xGn r• w �-H. O r C m r- O 0 n C ED O 0 O :1 3 !v CI 10 (] - ? n s1 O r m m m m mr r r t t o 00 n r N N N N r' tm La m m 1-3 N m WWWW � w 1•+ r r r r r r r r 0 0 0 0 0 0 0 0 0 GDWGDW A A A .P J J J J J J J J J GTI Vt cJt cr1 1 I 1 1 t ( I 1 1 Ln Ln Ln Gn GD %D %D %D GD %D GD GD �O W W W W A N A A A N W W A 38 April 22, 1993 To Whom It May Concern, Many of the students at Highland have participated in the Dental Hygiene program this year. The teachers report that the students learned alot and enjoyed it. This is a valuable program for a school such as ours. Some of our students do not receive this instruction at home and getting the training here is something they will use and benefit from all their lives. I hope that this program is continued. Sincerely, �Ithia Swainbank Principal Highland School 39 I PERES SCHOOL ■: o : a ;;; 0 O ■ bm o : I■ ," ® i . !r A ■ ® ; ; 719 — 575 SIRM �■ . o RICHMOND, CA r■ C. BRADFORD, PplimIPAL = G RECEIVED Public Health Dept. APR 121993 Clinic Services April 8, 1993 Director of Maternal, Child, Adolescent EL-alth 595 Center Avenue, Suite 120 Martinez, California 94553 Dear Sir/Madam: It gives me great pleasure to write this letter of commendation for the Dental Health Program of Contra Costa. This is our fifth year of participation in the program, and the results of student brushings and rinsings have proven to be effective in the fight with dental caries and poor dental health. The dental health staff has been very instrumental in providing staff inservices, demonstrations and classroom presentations. I feel the dental health program is well worth its cost, and I hope the program expands into all of Contra Costa County's schools. Sincerely, Charlene Bradford Principal CCB:jh 40 2000 RAILROAD AVENUE - TELEPHONE (510) 432.4705 PITTSBURG. CALIFORNIA 94565 FOOTHILL ELEMENTARY SCHOOL 1200 JENSEN DRIVE TELEPHONE (510) 432-8655 SAVE OUR SMILES DENTAL PROGRAM 595 Center Avenue Suite 120 Martinez, CA 94553 TO WHOM IT MAY CONCERN: The assistance we've received from your program is greatly appreciated by the staff and children at Foothill Elementary School. The children have been provided with excellent lessons on brushing, flossing, nutrition and dental disease. Many of the children's parents in our classes aren't able to afford to take their children to the dentist. The yearly dental screening provided by your program helped to eleviate some potentially serious dental problems. The referrals you made for free dental care was appreciated. Many families cannot afford to pay for dental care. The parents also found the dental information and brushing kits helpful in educating their children on home brushing. I feel that the dental health program has serviced our children well. I strongly support the program and appeal for its continuation. Sincerely, Eva Steffani Sol Rosenshein Leobardo and Ernestina Zamora Vicky Krywokulsky 41 � j4q3 Demographic Information by City Appendix A Contra Costa Countv 1990 Centus Data ANTIOCH BRENTWOOD CLAYTON White 76.3% White 64.3% White 88.6% Hispanic 15.6% Hispanic 31.8% Hispanic 5.3% Black 2.5% Black 0.7% Black 1.0% Asian/PI. 4.5% Asian/PI. 1.6% Asian/PI. 4.9% Amer.Ind. 0.9% Amer.Ind. 0.6% Amer.Ind. Other 2.0% Other 1.1% Other 2.0% Total 62,195 Total 7,563 Total 7,317 CONCORD DISCOVERY BAY EL CERRITO White 77.3% White 91.5% White 61.6% Hispanic 11.5% Hispanic 5.1% Hispanic 6.6% Black 2.3% Black 1.1% Black 9.0% Asian/PI. 8.3% Asian/PI. 1.6% Asian/PI. -22.2% Amer.Ind. 0.6% Amer.Ind. 0.6% Amer.Ind. 0.3% Other Other 0.1% Other 0.2% Total 111,348 Total 5,351 Total 22,869 EL SOBRANTE MARTINEZ PINOLE White 76.4% White 82.1 % White 65.4% Hispanic 9.4% Hispanic 8.4% Hispanic 9.8% Black 5.4% Black 3.2% Black 6.9% Asian/PI. 7.7% Asian/PI. 5.5% Asian/PI. 17.0% Amer.Ind. 0.9% Amer.Ind. 0.7% Amer.Ind. 0.7% Other 0.2% Other 0.1% Other 0.1% Total 9,852 Total 31,808 Total 17,460 PITTSBURG PLEASANT HILL RICHMOND White 47.2% White 84.6% White 30.6% Hispanic 23.7% Hispanic 6.6% Hispanic 14.5% Black 17.1% Black 1.4% Black 42.8% Asian/PI. 11.3% Asian/PI. 6.8% Asian/PI. 11.3% Amer.Ind. 0.6% Amer.Ind. 0.5% Amer.Ind. 0.5% Other 0.2% Other 0.1% Other 0.2% Total 47,564 Total 31,585 Total 87,425 TARA HILLS WALNUT CREEK WEST PITTSBURG White 65.3% White 87.4% White 55.4% Hispanic 12.8% Hispanic 4.7% Hispanic 21.6% Black 11.5% Black 1.0% Black 11.4% Asian/PI. 9.1% Asian/PI. 6.6% Asian/PI. 10.4% Amer.Ind. 0.6% Amer.Ind. 0.2% Amer.Ind. 1.1% Other 0.4% Other 0.1% Other 0.2% Total 4,998 Total 60,569 Total 17,453 43 APPENDIX B Fluoride Mouthrinse Guidelines APPENDIX C STATE OF CALIFORNIA DEPARTMENT OF HEALTH SERVICES DENTAL HEALTH SECTION FLUORIDE MOUTHRINSE PROGRAM Application For Program Approval Contra Costa County "Save our Smiles" Dental Program 4/16/93 (Name of Program) (Date of Application) 595 Center Ave. Suite #120 For School Year 1993 to 1994 (Address) Number of students this program Martinez , CA intends to serve: 94553 Program starting date 9/1/93 (510) 313-6284 (Telephone Number) Program ending date 6/15/94 Total # of weeks 38 N/A (Address-if different from agency) Frank Camodeca, DDS (Advisory Dentist) 2500 Alhambra Ave. Martinez , CA 94553 (Office Address) (510) 370-5300 (Office Phone) (Telephone Number) 2700 Winners Circle Lynn Pilant, RDH, BS (Home address) (Contact Person) Alamo, CA 2290 Holbrook Dr. (Home Address) 94507 Concord, CA 94519 (510) 798-7240 (510) 939-1450 (Home Phone) (Home Phone) 44 Fluoride Mouthrinse Guidelines Fluoride Mouthrinse Application Page 2 of 2 ATTACH THE FOLLOWING: 1. Letters of approval (or board minutes indicating approval) from: a) local health officer b) each participating school district 2 . Statement indicating fluoride levels in the community(ies) to be served by the mouthrinse program. If the program is proposed for use in a fluoridated community, a written justification must be included. 3 . Copy of blanket fluoride mouthrinse prescription 4 . Copy of parental consent form 5. Any local information which would support this application (Dental Health Section Use Only) Program approval is: granted provisionally granted-explanation attached denied-explanation attached For Project Chief, Dental Health Section Date 45 Contra Costa County Health Services Department PUBLIC HEALTH DIVISION c\ To: State of California Date: April 16, 1993 Dept. of Health Services Dental Health Section From: Wendel Brunner, M.D. s Subject: Fluoride Mouthrinse Program As per state requirement I am writing to support the implementation of a weekly fluoride mouthrinse program into the SB 111 targeted schools located in the sub-optimally fluoridated areas in our county. This includes the schools in the communities of Brentwood, Byron, Knightsen and West Pittsburg. Our Coordinator will implement this program according to the State's recommended procedure as outlined in the "Fluoride Supplement Guidelines" . The schools targeted to participate are: Byron Elementary, Discovery Bay Elementary, Knightsen Elementary, Brentwood Elementary, Garin Elementary, Bel Air Elementary and Shore Acres Elementary. They are scheduled to begin the fluoride mouthrinse program by September 30, 1993 . 46 fitsen Scfioof District 1923 Delta Road e P. O. Box 265 ADMINISTRATION Knightsen, California 94548 BOARD OF TRUSTEES VICKEY RINEHART (510) 625-0073 MARVIN COZBY SUPERINTENDENT Fax: (510) 625-8766 JAMES FRANK KAREN DUNCAN JUDITH GAMINO BUSINESS/ KAY LIDDINGTON SUPTS SECRETARY DOROTHY WALT�R April 20, 1993 Dear Sirs: I am writing this letter in support of the "Save Our Smiles" Dental Health Program, in which our elementary school participates each year. The dental educators' classroom presentations are excellent and the students look forward to them. We live in an area where the drinking water is not fluoridated, so the fluoride mouthrinse is an essential part of our program. We hope this program will continue to be funded. Education and pre- vention are very important for our children's health. Sincerely, Vickey Rine art Superintendent/Principal VR/kb 47 Byron Union School District CONTRA COSTA COUNTY 14401 BYRON HIGHWAY,BYRON,CALIFORNIA 94514-9251 (510)634-2128 FAX(510)634-9421 BYRON ELEMENTARY SCHOOL DISCOVERY BAY ELEMENTARY SCHOOL 14401 BYRON HIGHWAY 1700 WILLOW LAKE ROAD BYRON,CALIFORNIA 94514-9251 BYRON,CALIFORINIA 94514-9375 (510)634-2128 (510)634-2150 April 19, 1993 Dear Sirs: I am writing this letter in support of the "Save Our Smiles" Dental Health Program, in which our elementary school participates each year. The dental educators ' classroom presentations are excellent, and we appreciate the availability of brushes, floss, and fluoride. Because our drinking water is not fluoridated, the use of fluoride mouthrinse is especially important for our students. We hope this program will continue to be funded. Education and prevention are very important for our children's health. Sincerely, Charles Humbert Superintendent 48 APF,-2r—J5 Iut aa: ■.i - - :,r MT.DIABLO UJYIFrED SCHOOL DWMCT Z, //"° - J1A"W.DENT EDUCATION CE�It 19%r_artutta Drive Concord,Ca6kmia94519-1397 (510)682-8000 0 OFFICE OF SfUDEN7 ZRNICES I-FECAL ED(1GT]ON DIRECTOR April 27, 1993 M1EN40RANDUM To: "Save Our Smiles'Dental Health Program Department of Health Smices Contra Costa County From: Ken Duckett,Assistant Director XN7 Student Serviees,'Special Education RE: APPROVAL OF WEEKLY FLORIDE MOUTHRINSE PROGRAM. I am writing to provide the support of the Student Services./Special Education Department for the "Save Our Snvles"Dental Health Program. Three of our district schools,Bel Air,Rio Vista,and Shore Acres Mernentary Schools are in an unfluoridated water service arra and participate in this program. This program has served these schi ots for at least the past twelve years. We view this program as a safe and effective method for preventing dental canes In children and are hopeful that it can continue. It is our understanding that this program is conducted in accordanoe with recommended stair proccdurrs and that parental consent is necessary for student to participate. I would glad to provide any additional information that may be necessary to state our district's support for this program and on behalf of your efforts to maintain funding for it. Ajv EQUAL c TL7vn ,1a1-TMRTAE►Cr701VEWr BR Fax(510)6ao 2505 49 ' Brentwood School BKathy Hampton, Principal April 19, 1993 To: Contra Costa County Department of Health Services 'Save Our Smiles' Dental Health Program From: Kathy Hampton Subject: Approval of weekly fluoride program The intent of this letter is to support the weekly fluoride program that Brentwood School students participated in during the 1992-1993 school year. The staff and parents approve of this valuable program and recommend its continued inclusion in our dental health curriculum. It is extremely beneficial to our students now, many of whom do now receive regular dental care, and as an incentive to continue with fluoride treatment as a lifelong practice. It is our feeling that this program promotes a positive approach to dental health and physical health in general. 929 Second Street • Brentwood, CA 94513 • (510) 634-3408 50 FLUORIDE LEVELS IN COMMUNITIES SERVED BY THE FLUORIDE MOUTHRINSE PROGRAM Source of data: 1) Ledderer Laboratories, Concord CA 2) Brentwood Water District 3) Contra Costa Water District In the non fluoridated communities of Brentwood, Byron, Knightsen and West Pittsburg there exist three main sources of drinking water: well, city and non fluoridated bottled water. The waterplant supervisor, Mark Clarkson, reports that the natural fluoride range for Brentwood city water is . 06-. 39ppm. Water samples of several wells tested at Ledderer Laboratories showed a range of . 02-. 52ppm. 51 STATE OF CALIFORNIA DEPARTMENT OF HEALTH SERVICES DENTAL HEALTH SECTION TOPICAL FLUORIDE MOUTHRINSE PROGRAM Blanket Prescription For all K-6th grade children in the Contra Costa County school districts of; Byron, Knightsen, Brentwood and West Pittsburg. "Save our Smiles" Dental Program who have parental consent. Rx 0.2% neutral sodium fluoride mouthrinse Sig: Strain IOcc (one plungerful) of solution [NOTE: 5cc is recommended for children in kindergarten] forcefully between teeth once a week for one (1) minute, then expectorate. Nothing by mouth, including water, for 30 minutes following rinsing. Signature Date Wendel Brunner Name (Print clearly) . 597 Center Ave. #200 Copies: Original prescription should be kept on Address permanent file by the program coordinator and Martinez, CA 94553 a copy sent to the Dental Health Section with the initial or renewal program application. City, State, Zip (510) 313-6712 Renewals: A new blanket prescription should be written each school year by the advisory Telephone Number dentist, the local health officer, or other qualified dentist or physician. License Number 52 "Save our smiles,, Dental Health Program Parent Consent Form Dear Parents: Your child's class is participating in the "Save Our Smiles" Dental Health Program. It is conducted by the Contra Costa County Department of Health Services in cooperation with Brentwood, Byron and Knightsen School Districts, their staff and the Contra Costa Dental Society. The program will emphasize dental health education, promotion of dental health and prevention of dental disease. The goals of "Save Our Smiles" are to prevent tooth decay and gum disease, and to help your child learn the skills necessary to enjoy a lifetime with a healthy mouth. ACTIVITIES OF THE DENTAL HEALTH PROGRAM INCLUDE: 1. Teacher orientation 2. Student participation: A. Dental Health Educational Presentations B. Plaque removal, by -brushing and. flossing for 25 consecutive school days. (Flossing 4-6th grade only) . C. Weeklv Fluoride mouthrinsing- Under teacher supervision, students will rinse their mouths once a week for one minute with 10cc. (2 tsp. ) of 0.2% sodium fluoride solution. The U.S. Food & Drug Administration has approved this mouthrinse as a safe and effective way to prevent tooth decay. The rinse can be used in addition to other types of fluoride (toothpaste, dental office treatments, etc) to further reduce tooth decay. D. Dental Screenings by a dentist or dental hygienist will be performed on a sample of children to measure effectiveness of the program. This exam is non-diagnostic and does not take the place of a regular dental check up. Due to funding restrictions, your child may or may not be screened. The dental program is provided at no cost to, you or the school. In order* for your child to participate in the fluoride mouthrinse and screening components you must give WRITTEN PERMISSION. Please fill out the lower portion of this form and return to your. child's teacher as soon as possible. If you have any questions please call Lynn Pilant, RDH,, BS, Dental. Program Coordinator at 313- 6284. ----- ----—--——-----------------—---------—------ I want my child to participate in the total dental health program, including the fluoride mouthrinse and dental screening. My child may participate in all phases of the program except E J fluoride mouthrinse dental screening. CHILD'S NAME DATE OF BIRTH CHILD'S ADDRESS SCHOOL GRADE —TEACHER SIGNATURE OF PARENT OR GUARDIAN DATE 53