1987 Finalist
City of Minneapolis, Minnesota
Innovations in American Government Awards
Innovations in American Government Awards

Minneapolis has a large population of low income and minority children, many with parents who do not speak English. Approximately one-half of the Minneapolis Public School population is made up of minorities and the same proportion is eligible for subsidized school lunches. A large percentage of these children are Asian refugees. Before the Elementary School-Based Dental Care Program started in 1984, many of these children could not receive adequate dental care because their parents could not or would not take them to a dentist.

Dental problems not treated in childhood can result in pain and severe problems later in life. Parents do not take their children to dentists for two main reasons: either they cannot afford dental care or it is not convenient for them. Single working parents especially have difficulty because they often cannot take time from work for their children's dental appointments and the after work time demands of parenting are very high. Minority and welfare families often do not feel welcome in private or public clinics operated by predominately white dentists. Asian refugee families trying to obtain dental care face further obstacles. Because of cultural and language differences, they do not understand the need for routine dental care or how to go about getting the care, even if it is available at no cost through public programs.

The purpose of the Elementary School-Based Dental Care program is to improve the health of children by making dental care accessible and affordable. The program achieves its objectives by providing dental care on-site in elementary schools and in a centrally located clinic. Fees are charged on a sliding scale based on family size and income. In the last three years, the program has provided comprehensive dental care for over 10,000 children.

There are many advantages to providing dental care in the children's schools. There are fewer behavior management problems because the children are in a familiar environment and visits can be kept short to avoid traumatizing the children. Several short procedures are much easier on children than a single long appointment. Also, staff time can be used more efficiently when there is a steady source of patients. As patients are needed, they are simply called from the classroom. There are no broken appointments, which plague most public health clinics.

The program measures its success by tracking the number of patients served, and then calculating the cost per patient. In 1984, 4,636 patients were served at $75.63 per patient. By 1986, 4,865 patients were served, with a reduced cost per patient of $59.31. It is important to note, however, that these figures are for the entire dental program, not just the school-based portion. Separate data was not maintained for the school-based portion in 1986 because its costs were absorbed by the remainder of the program.