Working Together
for a Fit CNY

COMMISSION MOVES INTO ITS THIRD YEAR
Posted by on 10/ 11/2006


With the support of the Community Health Foundation of Western and Central New York, the Commission for a Healthy Central New York concluded its second year of funded operations during the month of October. The past year produced an organizational structure of subcommittees designed to address problems of obesity, dental health and mental health in the eight county area served by the Commission. This structure and the activities undertaken by the subcommittees are described below.

FitCNY Subcommittee.

A) Social Marketing—The Committee decided that it would be valuable to develop a strategy of providing healthcare providers with information and materials to assist them with providing care for obese patients. The sub-committee was formed, a white paper drafted describing the problem and project and a plan developed. The County Health Departments either held informal meetings with county providers regarding the issue of obesity or conducted an informal survey of providers on this topic. The goal was to learn about what they needed to improve care. Data has been reported in and will be analyzed and described. Simultaneously, the Family Medicine Department of SUNY Upstate intends to survey the physicians in the region on the topic of obesity including causes, perceptions, attitudes and treatments. The social marketing task force will tie its analysis of its informal research with Upstate’s survey to determine future directions.

B) Resource Guide- The Committee also developed a second task force charged with developing an on-line, regional resources guide making it easy for providers and the general public to identify local resources on issues of healthy eating, physical activity, counseling and other resource sites. The site is now functioning under the sponsorship of the Maxwell School at Syracuse University (http://fitcny.cp.maxwell.syr.edu). County Health Departments have received training on entering data and are well along in populating the site. A brochure describing the resource guide and its use was printed and distributed at the obesity conference and will also be sent elsewhere. The site will be a continuing work in progress.


In addition to these activities, the Commission undertook the task of organizing a regional conference on obesity entitled “Working Together for a Healthy Central New York”. This conference was successfully presented at the OnCenter in Syracuse on September 29, 2006. Over 200 participants were present at the conference and a quantitative evaluation is attached as an appendix to this report. Proceedings of the conference are being prepared and will be displayed on the Commission’s website.

Dental Health

Access to dental care was the focus of the Subcommittee’s work. A number of findings, recommendations and action steps came from this work.

1. A grant was submitted to the NYS DOH that would identify and apply Dental Health Professional Shortage Area Designation for appropriate areas in the region as well as a regional dental health assessment. Should this award be received, the Commission will contract to have the analysis performed.

2. The Committee supports a NYS DOH review of its policies regarding the licensing of foreign trained dentists. It is believed that NY has significantly narrower requirements than other states and this might be depriving New Yorkers of additional qualified dentists.

3. One of the identified barriers to care of Medicaid patients by existing dentists is the additional burden of program paperwork including pre-authorization. Staff contacted both the State Dental Foundation and NYS DOH regarding this problem. It was discovered that there has been an initiative to move to electronic billing that has stalled and this has affected the state’s willingness to discuss reforms of the paper system. The Committee will work with those trying to streamline the process.

4. A second barrier to private dentists accepting Medicaid patients was identified to be a high level of no-show patients at dental offices. Tompkins and Broome counties have instituted successful case management programs that includes follow-up but also includes facilitating patient compliance in advance. The problem here is funding of the case management positions. The Commission will also advocate for funding of case management.


5. The Commission currently is working with the Syracuse University Community Geographer to develop an on line regional map of dental office locations to assist those looking for a near by dentist. This project will be completed by the end of the year and will be made available through this website.

6. The group also identified the lack of dental hygienists as an access problem, but no specific plans have been developed. This problem may be partly addressed by a SUNY Potsdam extension project to train hygienists at the abandoned Griffiss Air Base.

7. In other areas, the Commission advocated an expansion of state funded dental sealants in upstate schools and developed a position paper for a dental resource guide and education.

As a part of advocating for increased access, the staff of the Commission participated in the NYS Oral Coalition’s Access Committee. The chair of the Dental Subcommittee will continue to work with this committee on access issues.

Mental Health

The Subcommittee concluded that access to mental health care services is a problem that is largely driven by the shortage of providers of mental health care. The problem is particularly acute in rural areas and for children with mental health needs. The solution to the access problem relates to the need for additional training capacity both at the postgraduate level in medicine (in adult and particularly pediatric psychiatry). The high cost of the training program limits the capacity.

Training of other providers in mental health care is also a key need. Models, like Upstate’s Psychiatry Department’s program in rural counties in the Hudson Valley to provide training, services and supervision on a contract basis, of relationships between academic medical centers and community providers to extend access were examined. One outgrowth of the relationships established as part fo the Subcommittee’s work is a similar relationship between Upstate Medical University with the Mental Health Department of Herkimer County which will lead to providing some tele-psychiatric services.

Areas for advocacy were also identified. These include attention to the limitations associated with insurance and financing mental health care, particularly the behavioral health care-outs utilized in the administration of insurance products, and the excessive paperwork associated with billing the traditional Medicaid programs for mental health services by primary care providers.

A common theme of sustainability threaded through the Subcommittee” discussions. Identifying programs that will extend access and capacity that can be sustained over time is a critical dimension.


The Future

The grant from the Community Health Foundation of Western and Central New York that supported the staff position at the Commission ends on October 18, 2006. Operations of the Commission will continue but without staff at this time. Questions may be directed to Tom Dennison, Chair of the Commission’s Advisory Council at thdennis@maxwell.syr.edu or 315-443-9060.