d se le ea R nd U er e th al ci ffi O fo In rm 9(2)(a) 9(2)(a) at n io Ac t 19 82 d se le ea R nd U er e th al ci ffi O fo In rm at n io Ac t Out of Scope 9(2)(a) 19 82 d se le ea R nd U er e th Out of Scope al Out of Scope ci ffi O fo In rm at n io Ac t 19 82 Out of Scope ?y?anax's'mrc?si 131}. HEALTH- muom Database number: 20182115 Out of Scope END. Page 4 of 4 Security classification: In-Confidence Date: 28/02/2019 Report No: File Number: 20180578 AD62-14-2019 io nf Position Telephone Team Leader, Oral 9(2)(a) Health, Population Health and Prevention 9(2)(a) Group Manager, Population Health, Population Health and Prevention Contact Order 1st Contact 2nd Contact R ea le se d U nd er t he O Grant Pollard ffi c ia lI Name Barbara Burt or Contact for Telephone Discussion (if required) m at Minister Clark Minister Genter Minister Salesa Deadline 6 March 2019 n Action Sought Note N/A N/A Ac t Action Sought 19 82 Health Report: Meeting with QIG and Te Aō Marama representatives, 7 March 2019 Page 1 of 5 Database number: 20190063 Security classification: In-Confidence 19 82 Quill record number: H201808578 File number: AD62-14-2019 Action required by: 6 March 2019 Meeting with Māori oral health providers’ Quality Improvement Group (QIG) and Te Aō Marama Hon Dr David Clark, Minister of Health Ac t To: R ea le se d U nd er t he O ffi c ia lI nf or m at io n Out of Scope Contacts: Grant Pollard, Group Manager, Population Health and Prevention 9(2)(a) Barbara Burt, Team Leader, Oral Health, Population Health and Prevention Page 2 of 5 Database number: 20190063 ffi c ia lI nf or m at io n Ac t 19 82 Out of Scope O 12. Targeted funding for adult dental care er t • I would like to see more affordable access to dental care for adults, as I recognise there is unmet need in this group. At the moment, a wide-ranging review of New Zealand’s health system is underway. It will provide a fresh perspective on delivering the best preventative health outcomes for all New Zealanders. U nd • he Talking points Ministry comment When you met with QIG in January 2017 you explained that you are interested in improving access to and affordability of adult dental care but that the Government is not in a position to do anything in this area during the current parliamentary term. se d • R ea le • • At present adult access to publicly funded oral health services is limited to emergency dental care for the relief of pain and treatment for infection provided through DHBs for CSC-holders, WINZ income-tested grants usually up to $300 per annum for urgent dental work, and dental care for hospital inpatients in specific circumstances. A background briefing on adult oral health was provided to you by the Ministry on 18 December 2018 [H201806264 refers]. Out of Scope Page 3 of 5 Database number: 20190063 U nd er t he O ffi c ia lI nf or m at io n Ac t 19 82 Out of Scope R ea le se d END. Page 4 of 5 Database number: 20190063 R ea le se d U nd er t he O ffi c ia lI nf or m at io n Ac t 19 82 Out of Scope Page 5 of 5 d se le ea R nd U er e th al ci ffi O fo In rm at n io Ac t Out of Scope Out of Scope 9(2)(a) 19 82 I MINISTRY 0'1: .. ITIEALTH HMJOIIA Database number: 20180003 Out of Scope Page 2 of 3 d se le ea R nd U er e th al ci Out of Scope ffi O fo In rm at n io Ac t 19 82 Out of Scope Importance of oralhealth of needing costly dental care in later years. Children and adolescents up to their 18th birthday have access to publicly funded basic oral health services. MANMU Good oral health matters to everyone's well-being, including in basics such as being able to eat, speak, smile and socialise. Poor oral health is largely preventable, yet it is also one of the common chronic health problems experienced by New Zealanders of all ages. A body of evidence suggests that poor oral health affects general health and shares a number of risk factors with other chronic diseases, including cardiovascular diseases, cancer, chronic respiratory diseases and diabetes. Government funding for oral health focuses largely on universal services for children and adolescents. Evidence indicates that oral health status at age five predicts oral health status at age 26. Facilitating and supporting good oral health from an early age helps set people up for life and thereby reduces the likelihood Most dental care for pre-school and primary school children up to school year 8 is provided by dental therapists within the Community Oral Health Service, which is provided by DHBs throughout New Zealand. Adolescents (from school year 9 up to their 18th birthday) receive DHB~funded dental care mainly from dentists in the community who are contracted by Dl-lBs. Emergency dental treatment is available through DHBs for relief of pain and treatment of infection for low income adults with Community Services Cards. The service is subject to user part~charges. Hospital dental services provide specialist-level oral health care, and dental services for people of all ages with disabilities, medical complications or behavioural problems. Work and Income New Zealand provides special needs grants for urgent dental treatment (usually a maximum of $300 per person per annum) for people on low incomes. In 2016/17 DHBs spent a total of $196.45 million (GST excl) on oral health servaces, broken down as follows: Community Oral Health Service: $101.08 Adolescent dental services: $38.04 Emergency dental care for low?income adults: $8.59 Hospital dental services: $48.74 There has been a significant government reinvestment In the East nine years Into the Infrastructure, model of care and capacity of child and adolescent oral health services. Since 2008 a reinvestment programme has provided $116 million additional capital funding to DHBs to build new fixed and mobile dental facilities for the Community Oral Health Service (COHS). An additionat $32 million each year in operating funding for the COHS has also been provided to DHBs to support the improved model of care that is part of the reinvestment programme. The new Community Oral Health Service operates from 176 fixed clinics and 157 mobile units, working at 1263 sites around New Zealand. A key aim of the reinvestment is to change the model of care from a reactive focus to a health?promoting model of care with a focus on family/whanau involvement, health education for self?care, prevention of ill? heaith, and early intervention. increasing parental engagement from an early age is critical to improving oral health for children. 1 Page Januat'y2018 Trends Performance measures between 20(57 and 2016 There are encouraging signs of improvement in child oral health outcomes over the past nine years. Between 2007 and 2016: . the percentage of pre?school children enrolled in the Community Oral Health Service increased from 43 percent to 85 percent of pre?schoolers the percentage of adolescents using DHB?funded regular dental services increased from 59% to 71% the percentage of children who are caries-free at age 5 increased from 51% to 60% (the results for Maori five-year-olds increased from 29% to 41% caries?free, and for Pacific five-year?oids from 29% to 34% caries- free.) . the average number of decayed, missing and filled teeth (DMFT) per child at school year 8 (12-13 years of age) has reduced improved) from 1.53 to 0.87. The results for Maori children reduced from 2.31 to 1.34 average DMFT, and for Pacific children from 1.79 to 1.30 average DMFT. HealthWorkProgramm - Oral Health Promotion initiative . The Ministry is delivering a health promotion initiative aimed at the parents and caregivers of preschool children, to promote regular toothbrushing with fluoride toothpasteand improve child oral health. Maori, Pacific and low income families/whanau are the priority groups. The initiative was rolled out in 2016/17 with the commencement of a social marketing campaign by the Health Promotion Agency. This campaign is continuing in 2017/18 and the distribution of toothbrushes and fluoride toothpaste to families/whanau and their young children is expected to commence in 2018. Decision-making on the fiuoridation of drinking?water supplies. . in 2016 proposed legislative changes were announced to allow DHBs, rather than local authorities, to decide which community water supplies are fluoridated in their areas. Moving the decision?making process from local councils to DHBs recognises that water fluoridation is a health-related issue. The Health (Fluoridation of Drinking Water) Amendment Bill (the Bill) passed its first reading on 6 December 2016 and the Health Select Committee report was presented to the House on 29 May 2017. The Bill is currently awaiting its second reading in the House. Electronic Oral Health Record . The Ministry is working with DHBs to achieve a consistent Electronic Oral Health Record for all DHBs. When implemented, the EOHR will contribute the oral health component of the comprehensive electronic medical record for patients. It is anticipated that the improved capture, quality and access to oral health data will support clinical decision making, provide operational efficiencies, improve patient experience and provide more robust and timely data for service development and planning. The next phase of the work will now focus on establishing work streams that achieve national consistency and service improvements through data quality, analytics, process improvements and enhancements to existing systems. The Healthy Ageing Strategy (HAS), 2016 . The HAS seeks to maximise the health and well-being of older people. HAS specifies three oral health priority actions for maximising older people's oral health, including Action 14(0): disseminate updated information and advice on dental care to older people, family and carers in communities, and aged cared organisations. This action relates to the delivery of oral health training to residential and domiciliary carers of older people. Since 2010, the Ministry has funded a programme of workshops, managed through New Zealand Dental Association, to provide oral health training to over 3,000 residential and domiciliary caregivers of older people. 2 Page January 2018